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THE PRINCIPAL HEALTH-RESORTS 



OF 



EUROPE AND AFRICA 



THE 



PEINCIPAL HEALTH-RESORTS 



OF 



EUROPE AND AFRICA 



FOR THE TREATMENT OF CHRONIC DISEASES 



c 



BY 

THOMAS MORE MADDEN, M.D., M.R.I.A. 
<• > 

VICE-PRESIDENT OF THE DUBLIN OBSTETRICAL SOCIETY 

LATELY EXAMINER IX OBSTETRIC MEDICINE IN THE QUEEN'S UNIVERSITY IN IRELAND 

PHYSICIAN TO ST JOSEPH'S HOSPITAL FOR SICK CHILDREN 

EX-ASSISTANT PHYSICIAN TO THE ROTUNDA LYING-IN HOSPITAL. ETC.. ETC., ET< . 



Uo 



1^1 



PHILADELPHIA 
LINDSAY AND BLAKISTON 

1876. 



CK 



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TO 

SIR MOSES MONTEFIORE, BART., 

AS A SLIGHT TEIBUTE OF ADMIRATION FOR HIS CHARACTER AS A 
PHILANTHROPIST ; 

HIS LONG-TRIED, UNTIRING, AND SIGNAL SERVICES TO HUMANITY 
WHEREVER OPPRESSED AND SUFFERING ; 

AND, ABOVE ALL, IN GRATEFUL REMEMBRANCE OF HIS PERSONAL 

KINDNESS. IN FORMER YEARS AND DISTANT LANDS, 

TO THOSE NEARLY AND DEARLY CONNECTED 

WITH THE AUTHOR, 

THIS VOLUME 
IS RESPECTFULLY INSCRIBED. 



PREFACE 



Change of climate and mineral waters are each year more 
largely employed in the treatment of nearly every form of 
chronic disease. Not withstanding the number of recent works 
on the subject, there is still a great deficiency of accurate 
information concerning even the most frequented health- 
resorts. For the majority of such books being either written by 
those residing in some sanatarium, the advantages of which are, 
perhaps unconsciously, exaggerated; or else being merely copied 
from these local advertisements, physicians at home are too 
often misled, and their patients abroad suffer the consequences. 
He who would attempt to supply the want of a comprehensive 
and reliable guide-book to the various foreign health-resorts 
should have extensive personal experience of many climes and 
places, and himself be a physician, — 

" — qui multorum providus nrbes, 
Et mores hominum inspexit." 

I may, therefore, premise that the following account of the 
principal Southern and Oriental winter asylums and Con- 
tinental spas, resorted to by British valetudinarians, is the 
result of my own observations during several years of health- 
travel in many lands. However much my opinions concerning 
some of these places may be found to differ from those of 



Vlll PREFACE. 

other writers, at any rate they have not been formed hastily, 
nor without experience of the localities I have sought to 
describe. For instance, one chapter — that on Malaga — is 
founded on my observations there during three successive 
winters, and another — on Lisbon — was written after a still 
longer acquaintance with that climate. 

For the favourable reception accorded to my former works 
on medical climatology and mineral waters I was chiefly 
indebted, next to the indulgence of my reviewers, to the cir- 
cumstances which had caused me to visit or reside in the 
various health-resorts I described. The accuracy of my 
account of these places has been since attested by the freedom 
with which they have been appropriated by some recent 
authors. I therefore venture to hope that the following pages, 
which have been so thoroughly re-written and revised, as 
to form a substantially new work, may be found useful to 
the travelling invalid, as well as to his medical adviser, as 
a comprehensive and trustworthy hand-book of the foreign 
Health-resorts and Spas. 

The therapeutic benefits derivable from change of climate 

and mineral springs have been somewhat unfairly ascribed 

solely to the cessation of drugging which generally takes place 

when a patient is sent abroad to a distant health-resort — 

" For change of air there's much to say, 
As Nature then has room to work her way; 
And doing nothing often has prevail'd 
When ten physicians have prescribed and fail'd." 

Apart, however, from this negative service, the positive 

remedial influence of change of air, and the potent effects of 

mineral waters, have been recognized in every age, and were 



PREFACE. IX 

quite as familiar to ancient and mediaeval medical writers 
as to those of the present day. Thus Hippocrates, throughout 
his works, and especially in the 45th of the second section 
of the AOOPI2MOI, lays great stress on the use of change of 
air, of country, and of modes of life. Ehazes, the Arabian 
physician of the tenth century, enjoins patients suffering 
from chronic disease — " Mutare de loco in locum, suscipere 
itinera longa et indeterminata." Savonarola of Ferrara, the 
father of the famous monk, and himself perhaps the most re- 
nowned medical writer of the fifteenth century, dwells much 
in his treatise on nervous maladies on the advantages of 
change of air — "elongatio a patria." Gordonius, another 
authority of the same period, advises that, in the event of 
medicines failing in the treatment of dyspepsia or hypo- 
chondriasis, the patient should be sent into distant countries 
— " distrahatur ad longiniquas regiones." " Lselius a Fonte 
Eugubinus," says Burton, " that great doctor, at the conclusion 
of one of his consultations, most expressly approves of this 
above all other remedies whatsoever." "Many other things 
helped, but change of air was that which wrought the cure, 
and did most good." " The sum of all," adds Burton, in his 
" Anatomy of Melancholy," " is that variety of actions, objects, 
air, and places are excellent good in this infirmity, and 
in all others, are good for man and good for beast." Sir 
Thomas Brown, who conjoined the highest qualities of a 
physician with those of a philosopher, observes — "He is 
happily seated who lives in places where air, earth, and water 
promote not the infirmities of his weaker parts, or is early 
removed into regions that correct them. . . . Death hath not 

b 



X PREFACE. 

any particular stars in heaven, but malevolent places on 

earth which single out our infirmities and strike at our weaker 

parts ; in which concern passengers and migrant birds have 

the great advantages who are naturally constituted for distant 

habitations, whom no seas nor places limit." 

It is not enough, however, to make long journeys in pursuit 

of health — 

" Ire per omnes 
Terrasque, tractusque maris, coelumque profundus." 

The invalid must make pleasant journeys, in good company, 
and, above all, if possible, in good spirits. " I pity the man," 
says Sterne, " who can travel from Dan to Beersheba, and 
cry ' 'Tis all barren ;' so it is, and so is all the world to him 
who will not cultivate the fruits it offers." And how often 
does the traveller meet in almost every place a tourist 
of the family described by the author of the "Sentimental 
Journey," who tells us that, " The learned Smellfungus 
travelled from Boulogne to Paris, 'from Paris to Eome, and 
so on ; but he set out with the spleen and jaundice, and every 
object he passed by was discoloured or distorted. He wrote 
an account of them, but it was nothing but the account of his 
own miserable feelings. I met Smellfungus in the grand 
portico of the Pantheon ; he was just coming out of it. ' It is 
nothing but a huge cockpit,' said he. He had been flayed 
alive, and divided, and used worse than St Bartholomew 
at every stage he had come at. Til tell it/ cried Smell- 
fungus, ' to the world.' . . . ' Sou had better tell it/ said I, 
' to your physician.'" 

Yery just was Yorick's advice ; for in ninety-nine cases out 



PKEFACE. XI 

of a hundred, this morbid state of mind arises either from 
some physical disease, of which it may occasionally be the 
only observable symptom, such as latent gout, hypochondriasis, 
or derangement of digestion — or else, it is a precursor of 
insanity, and, therefore, should be managed with extreme 
forbearance and kindness, and treated by suitable remedies, 
of which properly directed change of climate will often be 
found one of the most efficacious. 

The physiological influence of climate, although a subject 
of the highest practical interest in connection with the thera- 
peutic application of change of air, is far too wide a topic for 
consideration in this place. That the human constitution is 
powerfully acted on by climate is shown by the manifest 
effects produced by change of country and of air on indi- 
viduals in robust health, as exemplified by the history of all 
colonization, which clearly proves that the various races of 
mankind have each a certain fixed zone of temperature, within 
the limits of which alone they can permanently thrive. And 
though they may pass these boundaries for a short time, not 
only with impunity, but, as will be shown in the following 
pages, in many instances with the most striking remedial 
results, yet if their exile from their native atmosphere be too 
protracted, their constitutions become gradually altered, and 
their health and vigour impaired. Moreover, should they now 
marry and have children in the foreign clime, their offspring 
will be in all respects a degenerate race. 

Nearly all attempts on the part of Europeans to colonize 
tropical countries have been attended with these results. Thus 
the English, although two hundred years established in India, 



Xll PREFACE. 

have not succeeded to any extent in perpetuating their race in 
that country, and would long 'since have been expelled from it 
were not their numbers constantly recruited from the mother 
country. The Portuguese settled before the English in Bengal 
and Macao ; and not having been similarly reinforced, have 
lost almost every trace of their European descent — 

" 'Twas not the sires of such as these, 
Who dared the elements and pathless seas ; 
Who made proud Asia's monarchs feel, 
How weak their gold against Europe's steel ; 
But beings of another mould, 
Kough, hardy, vigorous, manly, bold ! " 

The power of acclimation is, of course, greatest in the 
inhabitants of the temperate zone, who, being habituated to 
sudden and frequent atmospheric vicissitudes, as well as more 
highly civilized than those of any other region, are better 
enabled to protect themselves from the perturbations of the 
atmosphere and inclemencies of the season. And it is within 
this zone that human life attains its longest average duration. 

The natives of either very cold or tropical countries affected 
by their climate, and not highly civilized, are incapable of 
extensive migrations, and succumb readily to great and 
sudden change of temperature. Several years ago I had 
an opportunity of observing the susceptibility of Australian 
aborigines to change of climate in the case of some native 
Western- Australian children, with whom I came to Europe. 
With them the cold, damp air of this country disagreed, 
and even the mildest atmosphere of Italy did not substitute 
for that of their own country, nor ward off death, which 
took place in one case within a couple of years time, not from 



PREFACE. Xlll. 

any distinct disease, but from general loss of health, apparently 
the result not only of the alteration of the mode of life, but 
still more the consequence of the chauge of clime, and, in 
another was only averted by the return of the patient to his 
native air. 

Did space admit it would be easy to show that it is not 
merely the physical constitution and bodily health of man 
which are influenced by climate, but that his national pecu- 
liarities are to some extent affected by this cause. Thus, for 
instance, the cold and ungenial, but bracing, climates of Switzer- 
land or Scotland, the rugged mountains they inhabit, and the 
sterile soil they cultivate, have probably assisted in developing 
the enterprising and hardy character of the Swiss mountaineer 
or Scotch Highlander ; whilst the flat and monotonous land of 
Holland, and its chill humid atmosphere, may thus have a part 
in forming the sluggish disposition and phlegmatic tempera- 
ment of the Dutch. The frequent changes of weather and of 
temperature to which the inhabitants of this country are ex- 
posed are, in like manner, reflected in the restless energy and 
mental activity of the people. Nor does the bright cloudless 
sky, and unvaryingly warm and sunny atmosphere of the south 
of Spain or Italy, less powerfully foster the poetic or imagina- 
tive faculties — perhaps at the expense of the more practical 
and sterner qualities of the mind. 

If such be the influence of climate on entire races, modify- 
ing not only their external form, the relative importance of the 
functions of many of their internal organs and the diseases 
that prevail in each isothermal zone, how great must be its 
influence on individual men, more especially when these are 



XIV PREFACE. 

in a weak and delicate state of health, and therefore infinitely 
more susceptible of all the good effects of a suitable change of 
air, as well as of the injurious results of inhabiting an un- 
healthy or unsuitable climate. 

The great majority of those who frequent the various winter 
resorts described in this work suffer from pulmonary disease, 
especially consumption or chronic bronchitis. In the first and 
second chapters I have shown how the former may, when, 
incipient, be warded off, or that, if already developed, in 
many instances it may be completely arrested in its progress, 
and also that the latter may be, in most cases, cured by a 
judicious change of climate. Besides pulmonary invalids a 
daily increasing proportion of the cases for which change 
of air is now prescribed is furnished by valetudinarians 
belonging to the wealthy classes of this country, who, having 
no necessary occupation, have become prematurely exhausted, 
or " used-up," by the laborious idleness of modern fashionable 
life, and imagine themselves to be ailing when, in fact, they 
are merely Uas4. The complaints of such patients consist of 
disturbances of functions, and a long train of nervous symptoms 
attributable to want of occupation, weariness of life, and 
lassitude ; which, though they do not amount to actual illness, 
will, undoubtedly, if not controlled and counteracted in due 
time, merge into confirmed disease. Long experience has 
proved that the most effectual way to prevent such a result 
is to travel in pursuit of health, and thus create something to 
do, something to look forward to, and to live for. 

If inaction of mind or body furnishes so large a number of 
valetudinarians requiring change of climate, the opposite 



PREFACE. XV 

condition is not less prolific of analogous cases. Amongst 
those whose position forces them to engage in too long-con- 
tinued intellectual labour of any kind, whether it be in over 
application of particular faculties or in inordinate exertion to 
attain a status in science or in society ; to avoid being trodden 
down or outstripped in the life-race of competition — there is 
no lack of ailing persons, dyspeptic and hypochondriacal, not 
absolutely sick, yet far from well, who must inevitably break 
down if they have not change of air, relaxation of mind, and 
removal from the sphere of their ordinary toils and cares. 

The chronic diseases just referred to, in which change of 
climate is resorted to with such advantage, are by no means 
as numerous as those which may be cured by the judicious 
employment of some of the spas, which are fully described in 
the Second Part of this volume. Amongst the maladies in 
the treatment of which mineral waters are more efficacious 
than any other remedies, may be included gout and the pro- 
tean complaints springing from the gouty diathesis, subacute 
rheumatism, rheumatic arthritis, scrofula in all its forms, dys- 
pepsia and hypocondriasis, sterility, and most of the chronic 
diseases peculiar to women. In a word, morbid conditions the 
most opposite, — those occasioned by an inactive life and those 
originating from over-taxed powers of mind or body ; plethora, 
and anaemia, the impoverished blood produced indirectly by im- 
perfect digestion or resulting directly from haemorrhage or dis- 
ease, and the vitiated blood laden with excess of nutriment, — 
are all, as will be shown, in many instances curable by 
mineral springs. In addition to those who thus really require 
the special curative action of some mineral source, a large num- 



XVI PREFACE. 

ber now visit the health-resorts of the Upper-Engadine, the spas 
of the Salzkammergut, or the other remote watering-places 
described in this volume, who merely find in the state of their 
health a plausible reason for indulging their innate and most 
legitimate inclinations for travel. There is a fear of being 
thought capable of seeking enjoyment for its own sake, pecu- 
liar to English professional men. But once introduce the plea 
of delicate health, and talk of change of air and mineral waters, 
and all such difficulties vanish. Though it certainly seems 
strange why the over- worked clergyman ; the lawyer, wearied 
out by pouring over briefs ; or the physician, jaded by what 
Dr Johnson contemptuously described as — " a continual 
interruption of pleasure; a melancholy attendance on 
misery," should of all classes of society be reluctant to 
admit that they go abroad for the pleasure as well as for 
the moral and physical benefit of change of scene and change 
of air. 

Properly used, travelling is the highest pleasure of which 
an educated and civilized man is capable, for it multiplies his 
enjoyments by crowding a greater number of impressions and 
sensations into a given space of time than anything else can 
do. An old English voyager has left so excellent a picture 
of the benefits of travel that I cannot refrain from quoting his 
words — "But what/' says Fynes Moryson, "if passengers 
should come to a stately palace of a great king, were hee more 
happy that is led only into the kitchen, and there hath a fat 
messe of brewis presented to him, or rather hee who not only 
dines at the king's table, but also with honour is conducted 
through all the courts and chambers, to behold the stately 



PREFACE. XV11 

building, pretious furniture, vessells of gold, and heaps of 
treasure and Jewells ? Now such and no other is the theatre 
of this world, in which the Almightie Maker hath manifested 
his unspeakable glory. He that sayles in the deepe, sees the 
wonders of God, and no lesse by land are these wonders daily 
presented to the eyes of the beholders, and since the admirable 
variety thereof represents to us the incomprehensible Majestie 
of God, no doubt we are the more happy, the more fully we 
contemplate the same." 

To no tourist is it so important to* know how to travel with 
advantage as to the valetudinarian pilgrim in pursuit of health ; 
for on this greatly neglected art depends the whole comfort 
and much of the benefit that may be derived from the journey. 
No people travel so widely as the English and none travel so 
well under difficult circumstances. Still no tourists seem to 
be less popular on the Continent. Nor is it improbable that 
those very qualities of endurance and resolution which so 
peculiarly fit British travellers for enterprises none other 
would undertake, incapacitate them from accommodating them- 
selves sufficiently to foreign habits and customs. It has been 
well observed that "the traveller should consider himself a 
guest when abroad, and observe the same conformity with his 
host's manners, as he would were he paying a visit to a private 
house." But, unfortunately, this good advice is practically 
ignored by the majority of our travelling compatriots, who 
indulge in incessant depreciation of all the manners and insti- 
tutions of foreign lands, or in invidious comparisons with 
something they think much better at home. As the Spaniards 
say, " Muchas veces la lengua corta la cabeza," and these rude 



XV111 PREFACE. 

speeches are among the principal causes of our unpopularity 
abroad. 

It may seem superfluous even to allude to the respect 
due by the traveller to the religious observances of the 
countries he visits, however much they may differ from his 
own. But I have more than once been present in foreign 
cathedrals when tourists, in the outward semblance of gentle- 
men, and I must add some dressed as ladies, have, by their 
grossly irreverent and scoffing demeanour, wantonly out- 
raged the most sacred feelings of congregations engaged in 
solemn worship. And, therefore, I feel justified in recom- 
mending any pilgrim in pursuit of health, whose zeal for his 
own faith is so strong that he cannot repress the manifestation 
of his intolerant contempt for the religious usages of others, 
not to seek a sanatarium beyond the limits of his own 
country. 

Next to his prejudices, his luggage is the great incumbrance 
of the traveller, and like them it should be reduced to the 
minimum, for it is always far better to buy whatever one finds 
wanting abroad than to have the trouble of carrying about 
unnecessary articles. 

The pilgrim in pursuit of health should, if possible, have 
some one of similar tastes and habits for his travelling com- 
panion. But the gregarious fashion of journeying now adopted 
by many is, I think, quite unsuitable for a valetudinarian, nor 
can I conceive any inducement which would persuade me to 
join one of the caravans of tourists who, not knowing anything 
of each other beforehand, bind themselves for a fixed period to 
perambulate foreign countries together *under the direction 



PREFACE. XIX 

of a conductor, and may be daily seen scouring through 
Continental cities after their leader, in the fashion of a flock 
of sheep following the bell wether. But this is a mere matter 
of taste and chacun a son gout. 

With regard to the plan of this work I need not say much. 
In the First Part I have given an account of the various 
southern health-resorts, prefaced with some observations on 
their special employment in different chronic maladies, par- 
ticularly consumption and other pulmonary affections. In the 
Second Part will be found a succinct description of the prin- 
cipal Continental spas, together with an account of the thera- 
peutic effects of mineral waters in various diseases. And in 
both parts I have endeavoured to combine all the general in- 
formation on these subjects which may be useful to the pre- 
scribing physician with all those local details that are neces- 
sary to the invalid traveller. Bearing in mind, however, the 
fact, too often lost sight of in similar works, that a hand- 
book should be portable as well as accurate, in order to accom- 
plish my purpose within the compass of a volume which will 
not add unduly to the incumbrances of the travelling valetudi- 
narian, I have condensed the descriptive portion as much as 
was possible without omitting any matter that seemed to me 
essential to its design. Should this book be fortunate enough 
to secure the approval of those for whose use it is thus 
intended, I trust on a future occasion to supplement it by a 
similar volume containing a full account of all the health- 
resorts and spas of Great Britain and Ireland. 

Although, for reasons already alluded to, in the following 
account of the foreign health-resorts I have relied mainly on 



XX PREFACE. 

my own notes and recollections of the various localities 
described, I cannot omit acknowledging my obligations to the 
resident physicians in nearly all these places, to whom I am 
indebted, not only for valuable professional information and 
important local details, but also, in many instances, for much 
personal attention and kindness. 



33 Merrion Square, South, 
Dublin, July 1876. 



ERRATA. 

Page 21, line 8, for " Tonas " read " Toros." 
Page 30, line 18, for " Fandas " read " Fondas." 
Page 139, line 22, for " Canards " read " Cornaro's." 
Page 145, line 15, for " Homberg " read " Homburg." 
Page 154, line 13, for " Homberg" read " Homburg." 



CONTENTS. 



PAET FIEST. 

ON CHANGE OF CLIMATE, AND THE SOUTHERN HEALTH 
RESORTS OF EUROPE AND AFRICA. 



PAGE 



CHAPTEE I. 

On Change of Climate in the Treatment of Phthisis, . 1 

CHAPTEE II. 

On Change of Climate in various Chronic Diseases, . 12 

CHAPTER III. 

The Mediterranean Coast of Spain and its Climates, . 1 8 

CHAPTEE IV. 
Cadiz, Seville, and Gibraltar, .... 23 

CHAPTEE V. 
Malaga, ........ 29 

CHAPTEE VI. 

Lisbon, ........ 42 

CHAPTEE VII. 

Madeira, ....... 48 

CHAPTEE VIII. 
Algiers, ........ 53 

CHAPTEE IX. 
Morocco, ....... 62 

CHAPTEE X. 
Pau, Arcachon, and Biarritz, .... 69 



XX11 CONTENTS. 



CHAPTER XI. 



PAGE 



MONTPELLIER, ....... 79 

CHAPTER XII. 

Hyeres and Cannes, . . . . . 83 

CHAPTER XIII. 
Nice, ........ 88 

CHAPTER XIV. 
Mentone and the Riviera, 93 

CHAPTER XV. 
Pisa and Rome, .,„.... 97 

CHAPTER XVI. 
Naples, .....,,. 102 

CHAPTER XVII. 
Palermo, . . . , . . . .106 

CHAPTER XVIII. 
Malta, . . . .109 

CHAPTER XIX. 

The Climates op Egypt, . . . . . 113 



PART SECOND. 

THE SPAS AND THEIR USES. 

CHAPTER XX. 

Preliminary Observations on the Spas, . . , 124 

CHAPTER XXI. 

On the Nature and Remedial Effects of Mineral and Ther- 
mal "Waters, . . . . . .126 

CHAPTER XXII. 

Dyspepsia and the Spas, . . . . 139 



CONTENTS. XX111 

CHAPTEE XXIII. 

Ox Gout and its Treatment by Mineral Waters, . . 142 

CHAPTER XXIV. 

On Mineral Waters in the Treatment op some of the Diseases 

peculiar to Women, ..... 146 

CHAPTER XXV. 

Chandfontaine, . . . . . .154 

CHAPTER XXVI. 
Spa, 156 

CHAPTER XXVII. 
Aix-la-Chapelle and Borcett, . , . .160 

CHAPTER XXVIII. 
Ems, 164 

CHAPTER XXIX. 

SCHWALBACH AND SCHLANGENBAD, . . . .166 

CHAPTER XXX. 

Wiesbaden, . . . . . . .171 

CHAPTER XXXI. 

Homburg, Nauheim, Neuenahr, and Kreuznach, . . 175 

CHAPTER XXXII. 

Weilbach and Soden, . . . . . .183 

CHAPTER XXXIII. 

Kissingen, Booklet, and Bruckenau, ... 186 

CHAPTER XXXIV. 
Carlsbad, ...... 191 

CHAPTER XXXV. 

Marienbad and Franzensbad, ... 197 

CHAPTER XXXVI. 

Teplitz, Bilin, Pullna, and Sedlitz, .... 203 



XXIV CONTENTS. 

CHAPTER XXXYII. 

(xASTEIN, IsCHL, AND BADEN NEAR VIENNA, . . . 209 

CHAPTEE XXXVIII. 

Canstatt and Wildbad, . . , . . 213 

CHAPTER XXXIX. 

Baden-Baden, . . . . . . . . 218 

CHAPTER XL. 
The Swiss Baden, . . . , . .221 

CHAPTER XLI, 

Schinznach and Wildegg, ... . 224 

CHAPTER XLII. 

Ragatz, Pfeffers, the Engadine, St Moritz, Tarasp, and Leuk, 228 

CHAPTER XLIII. 

Aix-les-Bains, ....... 236 

CHAPTER XLIV. 

Vichy and the Mineral Springs of Auvergne, . . 239 

CHAPTER XLV 

The Spas of the Pyrenees — Cauterets, . . . 245 

CHAPTER XLVI. 

The Pyrenean Watering Places, continued, , . 250 

CHAPTER XLVII. 
Dax, Passy, Auteuil, Enghien, Plombieres, and Contrexville, 258 

CHAPTER XLVIII. 
The Spas of Italy, ...... 263 

Index, . 271 



SOUTHEKN HEALTH RESORTS 
AND FOREIGN SPAS. 



PAET FIEST. 



ON CHANGE OF CLIMATE AND THE SOUTHEKN 
HEALTH EESOETS OF EUROPE AND AFEICA. 



CHAPTER I. 

ON CHANGE OF CLIMATE IN THE TREATMENT OF PHTHISIS. 

Of the large and yearly increasing number of invalids, more 
especially consumptive patients, who are now sent abroad 
to winter in the various southern health resorts described in 
the following pages, probably as many are injured by a wrong, 
or by a too tardy change of climate as are served by the 
judicious and timely use of this most valuable remedy. 
Patients as a rule will not abandon the comforts of their 
homes, or the avocations of their daily life, as long as they 
can cling to them ; nor do physicians generally prescribe this 
step until other treatment has failed, and then, when perhaps 
the disease is far advanced, the patient may be induced to 
try change of climate as a last resource. 

The temperature of a locality, to which so much importance 
is popularly assigned, is no criterion of its climate as a health 
resort. Thus in Algiers and Malaga I have frequently seen a 



A CHANGE OF CLIMATE 

sense of unbearable heat and exhaustion produced by the 
" Simoom " and " Terral " winds, without any corresponding 
alterations being occasioned in the readings of the thermo- 
meter. The fact being that invalids are painfully sensible of 
variations in the hygrometric state and electrical condition 
of the atmosphere, which are in no way indicated by this 
instrument, so much relied on. The effects of temperature 
depend chiefly on the hygrometric state of the air, and" on 
this is founded the division of winter resorts into dry, or 
tonic, and humid, or sedative climates. A dry, warm atmo- 
sphere stimulates the action of the heart and lungs, especially 
quickening the circulation in the vessels of the skin, and 
increasing its secretion and that of the liver, and consequently 
lessening the elimination from the kindeys. The diseases 
which prevail in hot, dry, tonic climates are, febrile, nervous, 
hepatic and cutaneous disorders. Most cases of chronic 
bronchitis, chronic rheumatism, debilitating mucous discharges, 
and some cases of asthma, are relieved in a very marked 
manner by an equable, dry, and 1 warm atmosphere. On the 
other hand, consumption, attended by symptoms of much 
irritation, with a short, hard cough ; dry asthma, and some 
cases of chronic bronchitis, where there is little expectoration, 
would be injured by a tonic climate. In so called sedative 
winter climates, the atmosphere is not only warm but humid, 
or even, as in some places, saturated with vesicular moisture. 
In such climates the eliminations from the skin and lungs are 
diminished, and the air necessarily containing less oxygen 
than an equal volume of dry air, the breathing is hurried, the 
process of respiration is less perfectly accomplished, and the 
nervous energy and muscular power of the emigrant invalid 
are diminished. These sedative climates, however, are suitable 
in some few instances of chronic pulmonary diseases, such as 
spasmodic asthma and chronic bronchitis, accompanied with 



IN THE TREATMENT OF CONSUMPTION. 3 

great irritability of the pulmonary mucous membrane and 
frequent hard, dry cough. 

A great change has come over medical opinion and practice 
with regard to the choice of health resorts for consumptive 
patients. Twenty years ago the great majority of these, 
irrespective of the type or stage of the disease, when S3nt 
abroad were recommended to visit sedative or humid warm 
climates, such as Madeira, Rome, or Pisa. At present, how- 
ever, nine-tenths of such patients are sent to winter on the 
Riviera at Mce, Mentone, San Remo, or in Malaga, or Upper 
Egypt, all dry, warm tonic climates; and in the greater 
number of cases this preference for a dry climate for the 
phthisical is certainly well founded. 

The mean temperature of a health resort is of much less 
importance for consumptive invalids than the rapidity and 
frequency of the transitions between its highest and lowest 
temperature, and preference should be given, ccetcris paribus, 
to that place which possesses the most equable, rather than 
the warmest winter climate. In the same way it is not 
sufficient to know the annual rain-fall in any locality, but we 
should take into account the number of days on which it rains. 
Thus at Cannes the annual rain-fall is about five inches more 
than in London ; but, notwithstanding this, Cannes is incom- 
parably a drier climate than London; the number of rainy 
days in the former being fifty- two, whilst in the latter it 
amounts to one hundred and seventy-eight. There is no 
circumstance connected with any health resort for pulmonary 
invalids of greater importance than the force and direction of 
the prevailing winds, and yet how much this consideration is 
generally neglected, will be manifest to any one who examines 
the position of some of the favourite winter resorts of southern 
Europe. 

Besides these, there are other reasons which serve to explain 



4 CHANGE OF CLIMATE 

why change of climate so often fails to benefit phthisical 
patients. One is the fact, that invalids who have put them- 
selves to the expense and inconvenience of going abroad 
for their health, are sometimes disposed to think that this 
should suffice for their cure; and, accordingly neglect all 
the other remedies, as well as those precautions which a 
consumptive patient requires in whatever climate he may 
reside. The last point I may allude to as a frequent source 
of fallacy respecting the value of change of climate in the 
treatment of consumption, arises from a faulty diagnosis by 
which other chronic pulmonary diseases are still confounded 
with it. 

My experience as physician to three large institutions in 
which the diseases of children are brought under my care, 
has confirmed the observation made in my first work on 
climatology several years ago, that there is no class of 
patients in whom we may more confidently hope for the 
beneficial effects of change of air than in the case of i children 
predisposed by the scrofulous diathesis, or by hereditary taint 
to consumption. The climate chosen for the treatment of 
this predisposition to tubercular disease should be dry, bracing, 
and equable. 

The division generally adopted of phthisis into three stages, 
is of practical utility in the remedial employment of change 
of climate. To be used with success change of air must be 
early had recourse to, and nothing can be more useless and 
more cruel than to send a patient in the last stage of con- 
sumption abroad, merely as a dernier resort. 

In the first stage of the disease, a tonic, or dry, warm, mari- 
time winter climate will be generally indicated. That is to say, 
that whilst the tubercular deposit and pneumonic inflammation 
is limited to a small portion of the pulmonary structure, the 
cough and dyspncea slight, and the pulse not very quick, a 



IN THE TREATMENT OF CONSUMPTION. 5 

change of air from this cold and humid climate, to a dry, warm 
atmosphere in winter, holds out a reasonable prospect of curing 
our patient. The climates which are best adapted for this 
condition are those of Upper and Middle Egypt, Western 
Australia, and Malaga. 

In the second stage of phthisis, a more sedative winter 
climate is generally required than in the first. But even in 
this stage four patients may be sent to a tonic winter climate, 
such as Malaga, for one that may be recommended a sedative 
climate, such as Eome, Pisa, Madeira, or one of our home 
winter resorts of the same class, such as Queenstown, Torquay, 
or Sidmouth. 

In the third stage of consumption, the expediency of 
change of climate becomes at times a subject of nearly as 
much anxiety to the conscientious physician as it is to the 
invalid under his care. In undertaking the risk of sending a 
patient in this stage of phthisis abroad, the physician must be 
guided altogether by the symptoms of each particular case, and 
the general condition of each patient ; and if the tubercular ex- 
cavations be small, and the infiltration of tubercles and accom- 
panying inflammatory action be limited to a small portion of 
the lung, the existence of the third stage of phthisis should not 
prevent us from giving our patient a chance of prolonging his 
life by a judicious change of climate. If, however, the patient's 
strength is much impaired; if the vomicae are large or 
numerous ; if the pneumonic inflammation and the tubercular 
infiltration be widely diffused, and if profuse expectoration, 
colliquative sweating, and diarrhoea are rapidly accelerating the 
termination of the disease, then the only result of sending a 
person in this condition to a foreign sanatorium would be, to 
deprive him of the consolations and comforts of home in his 
last moments. 

An eminent modern writer goes so far as to say—" If we 



b CHANGE OF CLIMATE 

have come to the conclusion that a consumptive patient has 
tubercles we ought not to send him to Nice, Cairo, &c, but 
ought to let him live his last days amongst his own friends and 
die in his own house."* From my own experience, however, 
I can contradict this theory, as I know a considerable number 
of persons in whose lungs tubercles undoubtedly existed, and 
who, had they been treated in accordance with this doctrine, 
would have " died in their own houses " many years ago, but 
being treated by a judicious change of climate are now not only 
alive but in good health. I have myself attended patients 
who, when they landed in Malaga, could hardly walk from 
the jetty to their hotel on the adjoining Alameda, so weakened 
were they by haemoptysis, unceasing cough, night sweats, and 
purulent expectoration, and who presented all the physical signs 
as well as the symptoms of a tubercular cavity in the lung ; 
and yet within a few weeks I have seen the same invalids so 
improved that they could ride to a picnic, enjoy themselves 
there, and return home late at night apparently none the worse 
for the fatigue and excitement they had gone through. But 
I do not say that in such cases this improvement was often 
permanent, and though the patient with characteristic hopeful- 
ness might fondly persuade himself that the disease had yielded 
to the remedial influence of the climate, yet in the majority 
of instances the symptoms slowly returned, and the fatal event 
was only postponed, for some time. 

Facility of access is a point of great importance in the 
selection of a climate for invalids. It is obvious that a 
patient should be sent to a place which may be reached by an 
easy journey, and that in case of need, he may communicate 
quickly with his physician and friends at home. 

With few exceptions the localities resorted to in winter by 

* " Clinical Lectures on Pulmonary Consumption," by Felix Yon Niemeyer, 
M.D., p. 7L 



IN THE TREATMENT OF CONSUMPTION. 7 

consumptive patients are situated on the sea ; and certainly 
this predilection is well founded, for such situations are more 
equable in temperature, being cooler in summer and warmer 
in winter, and less subject to sudden transitions or great 
extremes of temperature than inland places. 

As a general rule, therefore, I would select a locality on the 
sea-shore for the residence of consumptive patients, not only 
for the reason just mentioned, but also on account of the 
facilities for reaching such places by sea. As far as my 
experience goes, there is no remedy so beneficial and so 
universally applicable in cases of incipient consumption as a 
sea voyage. And even in those cases of confirmed consumption, 
when circumstances render a long voyage, for instance to 
Australia, impracticable, the patient may generally travel to 
his destination more advantageously by sea than by land. It 
is evident that the monotony of a sea life, and the gentle 
unceasing motion of a vessel must occasion less excitement 
and fatigue than rapid land travelling would produce. 

Change of air, however, appears to confer a sort of immunity 
on invalid travellers, who oftentimes when journeying undergo 
atmospheric changes and hardships which would probably 
have proved fatal to the same persons at home. Moreover, 
the change of living, of scene, and of place, and the freedom 
from the ordinary anxieties and duties of life, are as service- 
able to the general health of a consumptive traveller, as the 
warm genial atmosphere of a southern winter resort is to the 
pulmonary complaint from which he suffers. 

Preference should always be given to those winter resorts 
which present the greatest inducements and opportunities for 
open air exercise ; and no small part of the benefit derivable 
from removal to a southern health resort results from the 
opportunities afforded in the latter of being much in the open 
air, instead of being cooped up within doors as the patient 



8 CHANGE OF CLIMATE 

would be during the greater part of winter, had he remained 
at home. 

For those cases of phthisis in which the circumstances 
of the patient do not admit of the expense, or in which his 
state of health could not endure the fatigue of a journey to a 
foreign sanitorium in winter, we sometimes very advantageously 
have recourse to one of our moderately warm and equable 
British winter resorts, such as Torquay, Hastings, Worthing, 
or Bournemouth,, which are all sedative, or slightly humid, as 
well as sheltered climates. On the south-west coast of Ireland 
there are several localities possessing similar climatic advan- 
tages, and more especially along the shores of Kerry and Cork, 
which are exposed to the influence of the warm Gulf-stream, 
and are well protected by mountain ranges from cold northerly 
and easterly winds, such as Glengariffe and Dingle, where the 
arbutus, myrtle, and other southern plants grow freely in the 
open air all the year round, and which may be resorted to with 
advantage in the same class of cases as Sidmouth or Torquay. 
One of the most genial winter climates in the British Islands 
is that of Queenstown. 

It has been already observed, however, that these sedative 
climates are by no means universally serviceable to phthisi- 
cal patients, who more generally require a somewhat dry, 
tonic, moderately warm, and bracing atmosphere. Of such 
climates, unfortunately, the number is extremely limited 
in these islands, being chiefly confined to a narrow strip, 
about six miles in length, situated on the north-east coast 
of the Isle of Wight, i.e., the Undercliff, which undoubtedly 
possesses the best tonic winter climate for consumptive 
patients in the British Islands. There are, however, very 
many instances in which change of air is urgently required 
in the treatment of incipient phthisis, but in which the means 
of the patient do not admit of residence sufficiently prolonged 



IN THE TREATMENT OF CONSUMPTION. 9 

in any of the health resorts described in the following pages. 
And in some of these cases the physician might be able to 
suggest a locality where the consumptive emigrant might find a 
climate suitable for the cure of his disease, as well as a fair 
field for the profitable exercise of his regained health and 
vigour. My own personal acquaintance with colonial climates 
is limited to Western Australia and the Cape of Good Hope. 
The former, although the least prosperous of the Australian 
colonies, possesses one of the best climates in the world, being 
peculiarly equable, moderately warm, dry, and bracing. The 
Cape Colony, on the contrary, is subject to sudden atmospheric 
vicissitudes, rapid changes of temperature, and violent storms, 
which must render it ineligible for this class of invalids. 
But the uplands of the adjoining colony of Natal appear 
to offer peculiar climatic advantages for phthisical immigrants. 

It has been long observed that the inhabitants of elevated 
mountain districts appear to be peculiarly exempt from con- 
sumption, and an attempt has been made of late to turn this 
observation to practical account by recommending such localities 
as health resorts for the phthisical. It is, however, more than 
doubtful if the fact that the hardy mountaineers who inhabit 
Alpine districts and whose lives are passed under the most 
favourable hygienic conditions as regards pure air and exercise — 
the natural prophylactics against tubercular disease — are rarely 
attacked by consumption, can be regarded as a proof that these 
localities are therefore suitable winter resorts for patients 
already phthisical, and whose state of health would in such 
elevated, and oftentimes intensely cold and variable climates, 
probably confine them to the house in the new sanitariums of 
the Engadine, or other Alpine resorts, during the greatest part 
of winter. 

Still it would be difficult to deny or explain away the benefits 
which have been thus derived from mountain climates in the 



10 CHANGE OF CLIMATE 

treatment of certain cases of phthisical disease or predisposi- 
tion. 

Some years ago the late Dr Archibald Smith* called 
attention to the exemption from phthisis enjoyed by the inhabi- 
tants of some of the highest districts of the Peruvian Andes, 
and the benefits derived by pulmonary invalids sent by the 
local physicians from Lima to certain Andine valleys, such as 
that of Jauja, upwards of 10,000 feet above the sea. Since then 
similar advantages have been claimed by Dr Mattocks, f for 
the cold, dry, climate of the high table-land of the state of 
Minnesota, which lies nearly midway between the Atlantic 
and Pacific coasts of the United States. And also by Dr 
Weber, J Dr Kuchenmeister, § Dr Theodore Williams,1F and 
other recent writers for certain more accessible European 
mountain climates, especially St Moritz and Samaden in the 
Upper Engadine, Davos in the Grisons, Koningswart near 
Marienbad, and Gorbersdorf in Silesia. 

Of all the conditions necessary for a healthy climate one of 
the most essential is purity of the air ; that is, freedom from 
malaria or miasmatic emanation, or from the atmospheric 
contaminations produced by the crowding together- of vast 
bodies of men, or evolved by manufacturing or chemical 
processes. In this respect the Alpine climates of the Engadine 

* Dr A. Smith " On the Climate of the Swiss Alps and Peruvian Andes Com- 
pared." "Dublin Quarterly Medical Journal," vol. 91, p. 339. 

t Dr Mattocks' "Report on Minnesota." In Dr Horace Dobell's "Reports 
on the Progress of Practical and Scientific Medicine in Different Parts of the 
World," p. 8-24. London, 1870. 

J " On the Treatment of Phthisis by Prolonged Residence in Elevated 
Regions," by Herman Weber, M.D., " Medico-Chirurgical Transactions," vol. 
lii. p. 223. 

§ "Die Hochgelegenen Plateaus als Sanatorien fur Schwindsiichtige," von 
Dr F. Kuchenmeister, Vienna, 1868. 

II Dr Theodore Williams " On the Effects of Warm Climates in Consump- 
tion." " Medical Chirurgical Transactions," vol. lv. p. 237. 



IN THE TREATMENT OF CONSUMPTION. 11 

or the Andine valleys of Peru are unquestionably better situated 
than any of the health resorts of the Mediterranean. 

On the other hand, it must be borne in view that the height 
of a locality above the sea-level not only affects its temperature, 
which falls 1° for every 400 feet of altitude, but also, and still 
more directly, influences the pressure of the atmosphere, which 
at sea-level amounts to nearly fifteen pounds on every square 
inch of the surface of the body, and rapidly diminishes as we 
ascend above this ; and that the lessened atmospheric pressure 
of mountain health resorts must necessarily affect the balance of 
the circulation, giving rise to congestions or haemorrhages, and 
would appear to be especially contraindicated in cases of 
consumption, already predisposed to haemoptysis. 



12 REMEDIAL INFLUENCE OF CHANGE OF AIR 



CHAPTEE II. 

ON CHANGE OF CLIMATE IN VARIOUS CHRONIC DISEASES. 

The therapeutic influence of change of air is by no means 
confined to the malady spoken of in the last chapter, but is 
equally applicable, although less generally recognised, in cases 
of chronic bronchial and laryngeal inflammation, asthma, hypo- 
chondriasis, and the incipient stage of mental disease resulting 
from overwork, chronic rheumatism, and rheumatic gout, and 
above all in hysterical affections, and some other of the chronic 
diseases peculiar to women, which will be again alluded to in 
a subsequent chapter. 

There is hardly any chronic disease in which the remedial 
effects of change of air are so marked as chronic bronchitis, in 
cases of which I have often seen the mere change from town 
to a sheltered locality on the sea-side a few miles distant, cure 
a winter cough that no medicine could relieve. There are two 
varieties of chronic bronchitis requiring very different climates 
for their cure, — first, a form characterized by a hard, dry cough, 
with great irritability of the mucous membrane of the air 
passages ; and, secondly, that in which the disease debilitates 
and saps the constitution of the patient by profuse and con- 
stant expectoration. In the first, Eome, Madeira, or any 
other of the sedative winter climates may be advised. The 
second, and by far the most numerous class of bronchitic 
patients require a tonic or dry winter climate, such as Western 



IN CHRONIC DISEASES. 13 

Australia, Upper or Middle Egypt, Malaga, Mce, or Heyers. 
With some few patients Algiers, which holds an intermediate 
place between tonic and sedative climates, agrees better than 
any other. In chronic bronchial affections, however, it has 
been generally observed that occasional change of air is better 
than a continued residence in any climate however desirable. 

The foregoing observations apply equally to the climatic 
treatment of chronic laryngeal and asthmatic affections. 

Cases of chronic rheumatism, rheumatic-gout, and other 
diseases occasioned or aggravated by the sudden atmospheric 
changes, cold and damp, of this climate are necessarily 
benefited by a change to some warm, dry, and equable winter 
resort. I may here, however, caution rheumatic patients, 
who are sometimes recommended to winter in Pau, to avoid 
that climate; for not only is the disease in question very 
prevalent there, but also there is a great tendency to the 
sudden development of any latent cardiac affections which are 
so often met with in such cases. 

In cases of dyspepsia, change of climate oftentimes proves 
an effectual remedy. I shall, however, reserve any observa- 
tions on this subject for the second part of the present volume. 

There are few patients so little benefited by physic, and so 
generally served by change of climate, as those who suffer 
from hypocondriasis, in which complaint the moral effects of 
travelling are no less marked then the physical. The primary 
action of change of air in such cases, however, consists in 
improvement of the digestive functions, soon followed by a 
diminution of nervous irritability. Constant travelling for a 
few months will generally be found more serviceable than a 
prolonged residence in any health resort. It matters little 
where the tour be made, provided always that it be in a dry 
and bracing atmosphere, the object being to obtain a complete 
change ; and therefore the further from England and English 



14 REMEDIAL INFLUENCE OF CHANGE OF AIR 

associations the hypochondriac from these countries goes, the 
better. 

" The saddest and most humiliating subject of thought/' says 
Dr Johnson, "is the uncertain possession of the tenure of 
reason ;" and, unfortunately, it is a subject daily brought more 
prominently before us, by the steady annual increase of late 
years in the number of the insane in this country. Any 
means, therefore, which affords even a hope of checking this 
disease in its incipient stage, deserves attentive consideration. 
And that we do possess such a means in change of climate is 
unquestionable. 

There are now many predisposing causes of insanity to which 
our ancestors were much less exposed than 'we are. These 
evils are necessarily attendant on living in a densely populated 
state, where, by ill-directed education, divested of all moral 
control, the mind is prematurely exhausted and injured often 
at the very outset of the unceasing and increasing struggle not 
only for fame or fortune, but even for existence. 

In no malady is the adage " prevention is better than cure " 
more applicable than in incipient insanity, and in no disease 
are the good effects of change of climate so obvious. By this 
measure not only is the patient for a time removed from the 
circumstances and cares of life, by which his mind was over- 
strained, whilst by the change of occupation and scene new 
and more wholesome thoughts are suggested. 

" Haply, the seas and countries different, 
With variable objects, shall expel 
This something — settled matter in his heart ; 
Whereon his brain still beating, puts him thus 
From fashion of himself." 

Conjoined to this, are the good effects of the moral 
restraint which such patients usually exercise over them- 
selves, when in the presence of strangers, before whom they 



IN CHKONIC DISEASES. 15 

often succeed in concealing the manifestations of those 
peculiarities and eccentricities, which, were they allowed to go 
on unchecked, would probably lead to confirmed mental disease. 
Dr Willis, whose treatment of George III. brought him patients 
from every part of Europe, remarked, that insane people who 
were sent to him for advice from the Continent more frequently 
recovered than his English patients did, and Esquirol, of Paris, 
makes a similar observation. 

Some cases marked by excessive irritability require a mild 
sedative climate, and others, whose prominent symptoms are 
those of depression and languor, will demand a dry and 
stimulating atmosphere. But these varieties require a very 
careful appreciation and intimate knowledge of the symptoms 
of each case, and cannot be disposed of by any cursory general 
remarks. 

In some of the diseases peculiar to advanced age change of 
climate will be found the best adjuvant to our efforts to 
"Husband out life's taper at its close." This is especially 
the case in climacteric disease, when the patient becomes con- 
scious of a gradual decadence of all the mental as well as vital 
powers without any specific complaint, accompanied by longing 
for repose, which perhaps induced him to give up his long- 
accustomed avocations, and to retire to some quiet country 
place, in the futile hope that he may 

" Crown in shades like these 
A youth of labour with an age of ease !" 

But very soon the individual discovers that long-accustomed 
habits cannot be suddenly abandoned with impunity, and that 
a man who for the best part of his life has been an actor on 
the busy stage of city life, cannot in his old age learn to interest 
himself in rural pursuits, and having leisure for reflection finds 
that inaction is not rest, and that an active mind having no 
employment will prey on itself ; the result being a despondent 



16 KEMEDIAL INFLUENCE OF CHANGE OF AIE. 

spirit in an ailing body. Physic can do nothing to cure, and 
very little even to relieve such a state, and then it is that 
change of climate, which combines occupation with amusement, 
often proves an invaluable resource. 

Invalid travellers should bear in mind, that southern health 
resorts are not necessarily places where the chances of life 
for the fixed inhabitants are any better than those of even the 
most unfavourably situated parts of our own cold, damp, 
climate. On the contrary, in many foreign winter resorts no 
system of hygiene exists, no effective sewerage is provided, and 
no sanitary laws are enforced; and it is always therefore 
essential to forewarn invalids going abroad to winter of this 
drawback, and to urge them in such places to select their 
residence in an open situation fully exposed to the sun and on 
a rising ground. In most southern climates there is a 
tendency to occasional sudden transitions from the prevailing 
genial temperature to a keen sharp atmosphere accompanying 
certain winds, which if they occur frequently, render the 
locality unsuitable for a health resort. Moreover, the houses 
in these places are generally constructed with the view of 
affording protection from the summer heat, rather than shelter 
from the inclemency of winter. The narrow streets which 
exclude the sun, the large tireless apartments, with uncarpeted 
floors, the imperfectly closing casements, the height of the 
rooms, all indicate the necessity of a cautious and guarded 
manner of living. Avoidance of the night air is essential for 
pulmonary invalids in warm southern climates, where there 
is generally not only a rapid abasement of temperature after 
sunset, but also a profuse fall of dew during the night. 

I would further counsel every traveller in a warm climate 
to wear fine flannel inner clothing, no matter how hot the 
weather may be ; and also, as British prescriptions are seldom 
understood by foreign apothecaries, even when they may 



IN CHRONIC DISEASES. 17 

profess to dispense them, — a fact of which I have seen some 
unfortunate proofs whilst residing abroad, — I would recom- 
mend the invalid to find room amongst his impedimenta for a 
small stock of whatever medicine his physician may advise 
before leaving England. 

It too often happens that when patients go abroad they 
think themselves released from any observance of medical 
rules, which are as necessary to the invalid in foreign health 
resorts as at home, and not only " throw physic to the dogs," 
but indulge, without restraint, the appetite which travelling 
seldom fails to bestow, even in southern climates, where the 
quantity of animal food and alcoholic stimulants that may be 
consumed in this country are no longer required, and will 
not be tolerated by the system, and where the invalid traveller 
should impress on his mind the old Salernitan precept-— 

" Si tibi deficiant medici, niedici tibi fiant, 
Hsec tria, mens laeta, requies, moderata dieta." 



18 THE MEDITERRANEAN COAST OF 



CHAPTER III. 

THE MEDITERRANEAN COAST OF SPAIN AND ITS CLIMATES. 

The health resorts of southern Spain are within easy reach 
of English patients by railway direct from Paris, or by sea 
from Marseilles, whence there are, almost daily, steamers for 
Barcelona, and thence on to Malaga, with stoppages at all the 
intervening ports. Having more than once tried each of these 
routes, I have no doubt that, for an invalid, the latter is the 
best. 

Those who fear even the short passage across the stormy 
Gulf of Lyons may, as I have said, reach Barcelona by rail- 
way from Paris to Perpignan in twenty-five hours, thence by 
diligence to Gerona in eight hours, and again by train to 
Barcelona in four hours. My recollection of the fatigue 
and discomfort I endured during this journey is too vivid to 
allow me to recommend any ailing traveller to undertake it. 

The inconveniences of land travelling in Spain, away from 
the lines of railway which now connect all the great cities with 
the southern French lines, render this mode of peregrination 
unsuitable for the majority of valetudinarians. The way-side 
nns or ventas are generally small, the usual accommodation 
being limited to a single apartment, which serves as kitchen 
and saloon. This is commonly crowded with muleteers, who 
pass a considerable portion of the night in chanting some 
interminable ballad to the tinkling accompaniment of a guitar. 



SPAIN AND ITS CLIMATES. 19 

In these hostelries the fare and lodging are still the same as it 
was in that venta of which Purchas, an English pilgrim who 
visited Spain in the fourteenth century, has left an account. 

" Bedding there is nothing fair, 
Many pilgrims it doth afaire ; 
Tables use they none to eat, 
But on the bare floor they make their seat." 

Very soon, however, will such places be unknown, even in 
the bye-roads of Spain. Eailroads are fast intersecting every 
province, the telegraph crosses every mountain, steamers visit 
each port ; the camino de atajo will ere long be deserted ; the 
arriero and contrabandist a metamorphosed into railway porters, 
and the " posada " will be a thing of the past. 

To return from this digression on Spanish travelling, into 
which the diligence from Perpignan drove us, — Barcelona, 
which, from its position and importance, should be the 
capital of Spain, is situated on the sea, in a plain, nearly 
encircled by mountains, upwards of two hundred miles south- 
west of Marseilles, and contains a population of 150,000 
inhabitants. The town is intersected by the Rarribla, once the 
bed of a river, but now the most charming pas4o in all Spain. 
Here are situated the principal hotels, of which the chief are 
the Fonda de Quatro Naciones and the Oriente, as well as 
most of the cafes and theatres. The streets of Barcelona 
resemble those of a French, much more than a Spanish town ; 
nor are the manners, dress, or even the language of the people 
Spanish, as most of the lower class speak only the Catlan 
patois. 

The climate of Barcelona is humid and variable, being 
subject in winter and spring to cold northerly winds, which, 
alternating with a hot sun and warm southerly winds from 
the African coast, occasion an atmospheric constitution neces- 
sarily productive of pulmonary disease. The residents appear 



20 THE MEDITERRANEAN COAST OE 

to be well aware of the danger, since in the hottest summer 
day and the coldest winter weather, they are to be seen con- 
stantly wrapped in the same heavy woollen cloak ; and in 
going round the hospitals I was struck by the number of cases 
of phthisis and other forms of pulmonary disease. 

Barcelona would be a very unfit winter abode for any con- 
sumptive or bronchitic patient. During the month of January 
I have seen the thermometer at 7 a.m. as low as 36°, and the 
highest temperature during the day was 59° at noon. The 
cold winds which come down with great force from the high 
mountains behind the town, the intense cold which occasion- 
ally occurs, and the rapid variations from a very high to a 
very low temperature, all render this climate prejudicial to 
consumptive cases. 

The next port the steamer en route to Malaga touches at is 
Valencia, which, could we credit some writers, should be that 
happy clime that poets sing of, where — 

" Unbent by winds, unchilled by snows, 
Far from the winters of the west, 
By every breeze and season blest," 

the invalid might forget his ailments, and exult mentally and 
corporeally in all the influences of a genial and balmy atmo- 
sphere and never varying sunshine. But that, unfortunately, 
this is not the case a short view of the territorial and climatic 
aspects of Valencia will show. 

This province, of old a kingdom, extends about two hundred 
miles along the Mediterranean, varying in breadth from thirty 
to sixty miles, and mainly consists of a gradation of mountains 
and slopes ; which produce abundantly, figs, vines, and olives, 
and are considered dry and healthy in summer, while the low- 
lands, which are principally converted into swamps for the 
cultivation of rice, are justly regarded as the reverse. 

The city of Valencia is about three miles distant from the 



SPAIN AND ITS CLIMATES. 



21 



Mediterranean, one hundred and seventy miles to the south- 
west of Barcelona ; and, together with its environs, contains a 
population of upwards of 100,000 inhabitants. The streets 
still retain a semi-Moorish character, being dark, narrow and 
tortuous; the houses, too, have the flat roof peculiar to the 
East, and are lofty and sombre-looking. 

Valencia must be an extremely dull residence for foreign 
invalids; for when the Cathedral, Plaza de Tonos, and 
Hospital, — which latter is directed by sisters of charity, and 
is one of the most magnificent and best-conducted institutions 
for the sick poor that I have ever been through in any part of 
the world, — have been visited, little remains to be seen. 

The climate of Valencia is dry but changeable, and subject 
to rapid variations of temperature, the thermometer after an 
intensely hot day falling to a very low degree immediately the 
sun has set, from which time the atmosphere becomes charged 
with dew. According to Dr de Minano, the mean temperature 
of the months in this city is as follows : — 





o 


January, 


51 


February, 


55 


March, . 


59 


April, 


64 


May, . 


66 


June, 


71 



July, 


. . 78 


August, . 


77 


September, 


73 


October, 


66 


November. 


59 


December, 


46* 



During the months of January and February my notes show 
that on three consecutive days the mercury was considerably 
below zero at 7 A.M., and I have noticed a difference of 15° 
between that hour and midday. 

During the summer the heat is oppressive, the thermometer 
frequently standing for long periods at above 80° in the shade, 
nor is the sultriness of the atmosphere tempered by the sea- 



■ * " Diccionario de Espana y Portugal," par El Doctor Don de T Minano, 
p. 174. 



22 SPAIN AND ITS CLIMATES. 

breeze, which in most other Mediterranean cities renders this 
bearable. 

The prevailing winds are — the east, which passing over 
the sea is mild in winter, but at all seasons is humid; the 
west and south-west winds come next in frequency, and often 
blow with great force in winter, when they are cold and dry, 
and in summer are hot and parching. The north wind is also 
cold and dry, but is not prevalent, as the city is sheltered on 
that side by the distant mountains of Aragon. The most 
injurious, but, fortunately, the least frequent wind here is the 
south, which is moist and warm, and passing over the swampy 
rice grounds is pregnant with the seeds of malarious diseases. 

A climate such as this can hardly be suitable as a health 
resort. That it is not one for the consumptive is unquestion- 
able, and during my two visits to Valencia I ascertained that 
pulmonary diseases are prevalent. 

Passing by Alicante and Cartagena, which in a sanatory 
point of view present no attraction to the traveller in pursuit 
of health, we next arrive at Almeria, the Portus Magnus of the 
Eomans, now a very dull fourth-rate trading town, where most 
of the steamers stop a few hours. The view from the port is 
perfectly African in character. The barren coast and brown 
hills around, where not a particle of verdure grows, are in 
keeping with the ruined Moorish castle which stands on the 
summit of the mountain, and the small whitewashed houses 
below forming the town, the population of which amounts 
to about 19,000. 

There is now nothing of interest to be seen in Almeria, 
which, however, was one of the chief cities of Spain under the 
Moors, and almost the last of their strongholds. The climate 
is nearly the same as that of Valencia, but the hardness of the 
drinking water renders it still more unsuited to invalids. 



CADIZ, SEVILLE, AND GIBRALTAR. 



23 



CHAPTER IV. 



CADIZ, SEVILLE, AND GIBRALTAR. 



The south-west of Spain may be more easily reached by 
invalid travellers directly from England by sea than by any of 
the routes described in the last chapter. Every week there 
are departures from Southampton to Gibraltar, and also as 
often from Liverpool and London. The average duration of 
this voyage is five days, and its cost from Southampton £13. 
Many of these steamers touch at Cadiz, which struck me as one 
of the dullest towns in Spain, — the white walls which surround 
it hardly containing a single object of interest to a visitor, 
although this city is perhaps the most ancient in Europe, 
being founded, according to the local historians, three hundred 
years before Eome. 

The climate of Cadiz affords a striking example of the 
common fallacy of regarding the physiological action of climate 
as in any degree indicated by the mean temperature of the 
locality. The mean temperature of Cadiz is 62° ; winter, 52° ; 
spring, 59°; summer, 70°; and autumn, 65°; and the average 
temperature of the months is — 



January, 




51 


July, 




70 


February, 


53 


August, 


72 


March, 


55 


September, 


70 


April, 


59 


October, 


67 


May, . 


63 


November, 


58 


June, 


68 


December, 


53 



24 CADIZ, SEVILLE, AND GIBRALTAR. 

The variations of temperature are here effected with extra- 
ordinary rapidity, the situation of the town exposing it to the 
full influence of the easterly winds, which sweep through the 
Straits of Gibraltar. During the winter land winds from a 
northerly direction are most frequent, and in spring the pre- 
vailing winds are those from the sea. 

Catarrhal and bronohitic affections are common in Cadiz, 
occasioned by the ' atmospheric vicissitudes which render the 
climate unsuitable for any pulmonary patient. 

From Cadiz to Seville is but the journey of a few hours, 
either by steamer up the Guadalquivir, or by railway via 
Puerta Santa Maria and Jerez. 

By all true Spaniards Seville has always been considered 
the eighth wonder of the world. Their own proverb tells us — 

" Quien no la visto a Sevilla, 
No ha visto Mara villa." 

The streets of Seville, as in all the Saracenic cities of 
Andalusia, are narrow and crooked ; across them, in the hot 
weather, canvass awnings are spread from the over-hanging 
roofs of the opposite houses, and, owing to this contrivance, 
even in the intense heats of summer, when the neighbouring 
plain is burnt up to a barren waste, and when, as was the 
case during my visit, the Guadalquivir ran nearly dry, they 
maintained a delicious coolness. The principal streets 
are — the Calle de la Sierpe and the Calle Francos, both close 
to the Grand Plaza, which is one of the finest squares in 
Europe, and in summer is the fashionable lounge of the 
Sevillians, who here assemble to listen to the bands from eight 
or nine o'clock in the evening till long past midnight. The 
best hotels are in this square. 

Of the many monuments of ancient art, Christian as well 
as Saracenic, which Seville possesses, there is none comparable 



CADIZ, SEVILLE AND GIBRALTAR. 25 

to the Cathedral, which has no rival except St Peter's. Its 
foundation dates from the year 1407, when the chapter 
resolved to " erect a church so great and so good that there 
should be nothing equal to it." " Fagamos" said they, " una 
Eglisia tal que la poster •idad nos tengan por locos " (" Let us 
build such a church that posterity shall take us to have been 
mad "). From that time, this body voluntarily gave up their 
revenues and lived in community, in rigid poverty for more 
than a hundred years, until, finally, the sacred edifice was 
completed in 1519. " I do not hesitate," says Mr Eobertson 
"to characterise the Cathedral of Seville as the noblest 
temple in Christendom." 

The Alcazar, which was built on the ruins of the palace of 
the Eoman praetors of Seville by the western caliphs in the 
10th century, is the most perfect specimen of Moorish art 
remaining in Andalusia, with the exception of the Alhambra 
of Granada. 

Notwithstanding all its unrivalled attractions of an artistic 
and antiquarian character, Seville has little to recommend it 
as a sejour for the pilgrim in pursuit of health. The climate 
is characterised by the tendency to sudden variations of tem- 
perature, which is common to most of the southern cities of 
Spain, though in very few of them is this so marked as in 
Seville. 

The winter is not as warm or equable here as it is on the 
sea coast. But even at this season the actual cold experienced 
is seldom very intense, for as Dr Gigot Suard states, "the 
average temperature during the coldest days is from 39° to 41° 
at sun-rise, and 50° to 55° during the rest of the day." * 

In summer the excessive heat of the day contrasts strongly 
with the piercing cold of the nights. The cold wind, to which 
the sudden nocturnal abatement of temperature is due, brings 

* "Des Climats sur le Rapport Hygienique et Medical," p. 561. 



26 CADIZ, SEVILLE, AND GIBEALTAR. 

with, it, in addition to catarrhal and rheumatic affections, con- 
tinued and intermittent fevers of a typhoid character, which 
are particularly severe and common in the environs of the city. 

Such a climate, and the diseases to which it gives rise, for in 
winter catarrhs, bronchitis, and other pulmonary complaints, 
sometimes leading to consumption, are prevalent, should warn 
us that mistrusting the fallacious brilliancy of the sky, and 
purity of the atmosphere, we should beware of sending patients 
suffering from diseases of the respiratory organs, and especially 
phthisical invalids, to winter in Seville. 

I have no doubt, however, that in certain other chronic 
maladies the climate of Seville might prove very beneficial. 
I would include under this head many cases of chronic gastric 
and liver disorders, and general relaxation of fibre, resulting 
from long residence in tropical climates, and which unfit the 
individual for withstanding the cold and damp of our northern 
winters. 

The most southern point of Europe, Gibraltar, demands a 
brief notice in this place, having been recommended by some 
writers as a proper winter residence for invalids, and also 
because all the steamers from England to the South of Spain 
touch here. Gibraltar is situated at the entrance of the 
Mediterranean, fifteen hundred miles from Southampton, form- 
ing a rocky peninsula nearly three miles in length, and 
separated by a narrow sandy isthmus, which can be laid under 
water at any time, from the main land. The rock rises 
abruptly to a height of 1400 feet, and is intersected by deep 
gullies, which act as reservoirs for the rain water, and add to 
the general unhealthiness of the locality by the evaporation 
they cause in summer and autumn. The population of the 
town is upwards of 15,000, exclusive of the garrison, which 
varies from 4000 to 5000 men. 

Excepting for military men Gibraltar is a most uninteresting 



CADIZ, SEVILLE, AND GIBRALTAR 27 

place. On no account should the invalid traveller be per- 
suaded to see the "galleries" in the rock usually visited by 
tourists, as in order to do so he must first undergo the long 
ascent to the commencement of the cuttings, where he will 
arrive fatigued and heated, and then suddenly will be exposed 
to the bitterly cold, damp air, which rushes along these 
passages, and which cannot fail to injure weakened or diseased 

lungs. 

A great drawback to Gibraltar is the want of good drinking 
water, for that principally used is rain water, which being kept 
in limestone tanks becomes a prolific cause of calculus and 
other diseases. 

The climate of Gibraltar is very similar to that of the 
northern coast of Africa, to which its position so nearly 
approximates, being, however, somewhat modified by the 
almost insular situation of "The Bock." The mean annual 
temperature is 64°, the maximum being 92° in July, and the 
minimum 32° in February. The mean daily range of tempera- 
ture is 13°. The mean temperature of winter is 58° ; that of 
spring 66° ; summer 77° ; and autumn 67°. 

These thermometrical details cannot, however, be relied on 
as indications of the climate, for we shall often find in Gibraltar 
that when the sun is most powerful, and the thermometer 
consequently stands highest, at the same time a cold, searching, 
easterly wind prevails, and even in the warmest weather the 
shady sides of the streets are often felt to be unpleasantly 
chilly. 

The position of Gibraltar between the Atlantic and Mediter- 
ranean accounts for the prevalence of strong winds, especially 
from the east, on which side the town is much exposed. 
Easterly winds occur on an average for 177 days annually, and 
generally prevail from July to November, which is regarded as 
the unhealthy season ; for this wind, which is so violent as to 



28 CADIZ, SEVILLE, AND GIBEALTAE. 

render the bay of Gibraltar unsafe for shipping while it lasts, 
being besides saturated with moisture, is no less injurious to 
the pulmonary invalid. The westerly winds, which prevail on 
an average for 188 days in the year, blow directly on the town, 
but are dry and clear, and are usually considered healthy. 

The year may be practically divided at Gibraltar into two 
seasons, the rainy and the dry, the first commencing about the 
end of September with very violent rains, which fall at intervals 
until May, when the dry season succeeds. Thus in an average 
year, from the 4th of August to the 1st of November, only 
5 inches of rain fell, while from the 1st of November to the 
30th of January, inclusively, 29 inches fell. The average 
annual rain-fall, however, is but 34 inches. 

The autumn months here are damp and unhealthy, the 
atmosphere is thick and foggy, and heavy dews fall at night. 

The mortality at Gibraltar is, as it always has been, very 
high. " It is especially observable," says Captain Sayer, civil 
magistrate at Gibraltar," that although the population has 
been gradually decreasing since 1840, the death-rate has been 
gradually increasing." The prevalent diseases are consumption, 
affections of the pulmonary organs, and fevers. 

In the last Eeport of the Army Medical Department we find 
that out of a garrison of 4341 men, no less than 2543 were 
admitted into hospital during the year.* 

From the preceding details it will be seen, that the climate 
of Gibraltar is prejudical to all invalids, and more especially 
so to consumptive patients. The combination of an intensely 
hot sun and cold wind, the great variation of temperature 
between the sun and shade, the badness of the water, and the 
evils peculiar to a small garrison town, all conduce to a state 
of things hurtful alike to the moral tone and physical condition 
of the inhabitants. 

* " Army Medical Department Keports," vol. xv, p. 56, London, 1875. 



MALAGA. 29 



CHAPTEE V. 



MALAGA. 



Malaga is one of the best winter-resorts in Europe for con- 
sumptive patients requiring a warm, dry, tonic climate. I 
have had great reason to speak favourably of this place, not 
only from my own personal experience of its benefits some 
years ago during three winter seasons, but also from a con- 
siderable number of cases in which I have since then recom- 
mended this climate with advantage. 

The city of Malaga is situated eighty miles to the eastward of 
Gibraltar, on a deep and beautiful bay, surrounded by an ex- 
tensive plain, the vegetation of which is almost tropical in 
character, opening on the Mediterranean to the south, and pro- 
tected on the north, west, and east, by the lofty mountains of 
Konda, Antequerra, and the Sierra Nevada. 

From Paris this health resort may now be reached in three 
days by railway via Madrid and Cordova ; but I should not 
advise this very fatiguing journey to any invalid traveller who 
may in preference select one of the routes mentioned in the 
last chapter. 

Of the early history of Malaga we have no authentic 
record until the year 711 a.d., when the Moors invaded 
Spain, from which time this place gradually rose into a 
city of great commercial importance. Some vestiges of its 
former greatness may yet be seen in the ruins of the castle on 



, 



30 MALAGA. 

the hill, and in the Atarazanas, or arsenal, in the falling walls 
of which still rust the rings to which the Moorish galleys 
were once secured, though it is now nearly half a mile from 
the sea. The long-enduring sway of the Saracens in Malaga 
terminated in 1487, when Ferdinard "El Catholico," after a 
siege of three months, entered the town. 

Since then, with the exception of its having been attacked 
by Admiral Blake in .1658, and again captured by the French 
under Sabastiani in 1810, Malaga has enjoyed a comparatively 
tranquil existence down to a very recent period, when a series 
of republican and communistic " pronunciamentos," or abortive 
revolutions, having broken out and been put down, this place 
has again settled down into a prosperous but dull commercial 
town, and now contains a population of about 120,000 
inhabitants. 

The principal hotels are the Alameda, Victoria, and Oriente, 
which are situated close together on the Alameda. The 
usual charge in these " Fandas " is from thirty to forty reals, 
or from six to nine shillings a day, this tariff including all 
the ordinary expenses of living. 

The Alameda or fashionable promenade, which at the com- 
mencement of this century was partly covered by the sea, is 
now separated from it by a couple of intervening streets, and 
extends from the port on one side to the G-uadalmedina or 
river of the city on the other, being about half a mile in length. 
Owing to the gravelly absorbent nature of the soil, which dries 
very quickly after rain, the Alameda affords the best pro- 
menade in Malaga, unless when the t erred or levant e winds, 
to which it is exposed, prevail. At all other times this walk 
is the great resort of the foreign visitors. Here, too, may be 
seen the sturdy contrabandista from Eonda, wrapped up to the 
eyes in the folds of his ample cloak, basking in the warm 
sunshine, or the tall peasant from the mountains in his pictur- 



MALAGA. 31 

esque Andalusian costume, slowly stalking along with all the 
grave dignity of an ancient Eoman. 

" There of Nuniantian fire a swarthy spark 
Still lightens in the sun-burnt native's eye ; 
The stately port, slow step, and visage dark, 
Still mark enduring pride and constancy." 

Next, perhaps, passes a solemn Padre, reciting his breviary 
beneath the shade of a sombrero nearly three feet long, or more 
numerously the dark-eyed senoritas gracefully trip along, 
exchanging electric glances and telegraphic signals from the 
pliant fan with the young caballeros, who, during the time 
of promenading, ride round and round the Alameda. 

All the public buildings of Malaga are small and tasteless 
except the Cathedral, a vast structure commenced in 1528, and 
which still remains unfinished. The choir contains some very 
beautiful specimens of wood-carving, attributed to Alonzo 
Cano, as well as a few good pictures. These, however, can 
hardly be seen, owing to the Spanish custom of darkening the 
windows, although the general effect, is certainly rendered 
more impressive by — 

" The solemn gloom, 
Of the long Gothic aisle and stone ribb'd roof, 
O'er canoping shrine and gorgeous tomb, 
Carved screen, and altar glimmering far aloof, 
And blending with the shade." 

There is a great contrast between the* modern part of 
the town near the Alameda, and the older portions, which 
have undergone little change for the last three centuries. The 
latter are connected with the port by a street which intersects 
the city, crossing the Plaza de la Constitucion and the Plaza 
de la Merced, and terminating in the Calle de la Victoria, so 
named from the triumpha entry of Ferdinand and Isabella 
into Malaga. The streets in this quarter are extremely narrow 



32 MALAGA. 

and dark, and the massive houses, with their grated windows, 
have externally a gloomy and eastern appearance. 

The rooms are spacious and lofty, though for the most part they 
are but sparingly furnished. Fire-places are generally unknown 
here, their place being supplied by the hraseros or pans of char- 
coal, which are but a poor substitute for the cheerful blaze of an 
open fire ; and the invalid on those few occasions, when he may 
feel inclined to regret the comforts of an English fire-side, will 
do well to wrap himself in his cloak, or retire to bed, rather 
than sit poisoning himself over the noxious fumes of smoulder- 
ing charcoal. 

With respect to the living, it must be admitted that the 
meat in Malaga is very inferior, in every respect, to that 
used in this country. The fish, however, is so good, and 
of so many various kinds, as in great measure to make up for 
the shortcomings of the animal food, and invalids may manage 
to live very well and very cheaply at the hotels on fish, kid, 
poultry, game, especially partridge, which is a standing dish 
here, even if they do not choose to venture on the meats 
served at the table d'hote. 

Spanish cookery is generally considered as intolerable by 
British travellers, but I think this is mere prejudice; and 
that garlic and oil, which enter so largely into all culinary 
operations in Spain, are absolutely necessary (moderately 
used) to supply the want of fat and of flavour in the meat, 
and to render it digestible. 

The physician who sends his patient to Malaga, should 
impress on him the great importance of choosing an apartment 
having a southern aspect, as there is often a difference of 
10° in the temperature of rooms facing the Alameda, and 
those at the back of the hotels. Besides the mere warmth, 
the front rooms are more cheerful, and enjoy the advantage of 
free exposure to the light and sun, a very essential matter for a 



MALAGA. 33 

pulmonary invalid, who should recollect the Italian proverb — 
" Where the sun does not enter the doctor must." 

The hygienic condition of Malaga is as defective as it can 
well be. In a great many of the houses there is no provision 
for sewerage of any kind, and even in the more civilized part 
of the city, on the Alameda, the drainage is very bad indeed. 

It might be anticipated, from the great antiquity of this city, 
and the high civilization of its successive conquerors — Greeks, 
Eomans, and Saracens — that the antiquary might here reap 
an abundant harvest of treasures of the olden time, but such is 
not the case. The various races who have in succession peopled 
this fair land, have all, with envious haste, endeavoured to 
obliterate any trace of their predecessors. For instance, the 
beautiful Moorish arch of the Atarazanas, which time had so 
long spared, was not long since built up with brickwork and 
totally defaced; and of the Greek and Eoman monuments 
described in the " Conversaciones Malaguenas," at the end of 
last century, hardly one now remains. 

The chief resource for invalids in Malaga lies in the beauty 
and variety of the walks and rides in the vicinity, which, 
thanks to the usual fine weather, are nearly always accessible. 
One of the most beautiful of these excursions is that along the 
Granada road, behind the town, between the cemetery and 
Moorish aqueduct, and ascending the mountain until we come 
to the point where the road turns away from the sea, the view 
from which is one of the finest imaginable. In front rise the 
snowy peaks of the Sierra Nevada ; to the south, the Atlas 
Mountains of the opposite African coast, fully eighty miles 
distant, are clearly defined ; while from west to east the vista 
includes an uninterrupted prospect of the Mediterranean from 
Gibraltar to the point near Velez Malaga. From this vast 
range of view, the eye falls back with relief on the fertile plain 
around the town, thickly planted with groves of oranges, olives, 

c 



34 MALAGA. 

and sugar-cane, and every eminence covered by the vine. In such 
a scene the invalid may, for. the moment, forget all the ills that 
flesh is heir to, and abandon himself to the enjoyment of — 

" Forest and village, lawn and field, 
Ocean and earth, with all they yield 
Of glorious or of fair." 

Another favourite ride is through the Vega, by the Churriana 
road to the grounds of " El Ketiro," the country seat of the 
Conde of Alcolea, some five miles from the town. These 
gardens, when I first visited Malaga, were much resorted to by 
pic-nic parties, and I have here seen invalids, who at home 
never breathed the noon-day air except through a respirator, 
without any precaution whatever, dancing in the open air, in 
December or January, and suffer from no consequent ill result. 
Very pleasant excursions may also be made to Velez Malaga, 
Alhaurin, and Antequera, and to the sulphurous baths of 
Carratraca, which are much resorted to in cutaneous affections, 
as well as in some cases of chronic rheumatism and dyspepsia, 
by those who can bear with impunity the attendant fatigue and 
roughing ; and now by railway to Cordova and Granada. 

Society in Malaga is almost entirely confined to the 
mercantile class, many of whom are eminently hospitable and 
courteous to strangers ; among the ladies, too, there are not a 
few who fully justify the proverb that " Las Malaguenas," son 
muy halaguenas, " are very bewitching." The Malaguenians of 
the lower order, it must be admitted, bear a very indifferent 
character throughout the rest of Spain, being regarded as 
addicted to gambling, fond of drinking, not recognising the 
distinction between meum and tuum, and especially are given 
to the use of the knife, which even in trivial altercations is 
drawn as readily as the fist would be resorted to in England. 

Such are the characteristics which distinguish the lower order 
of Malaguenians from Spaniards generally, who, and more 



MALAGA. 35 

especially the Northern Spaniards, are as kindly, brave, trust- 
worthy, industrious, and self-reliant a people as any in 
existence. But in Malaga the great deterioration is probably 
in some degree occasioned by the exciting and often variable 
nature of the climate reflected in the passionate and uncertain 
character of the inhabitants, who are further altered from the 
national type by their semi-Moorish descent, and by the 
admixture of races common to all large seaports. 

The climate of Malaga is of a dry, warm, and equable 
character, the thermometer varying little during the day, except 
when the " terral," or " levante" winds prevail, both of which 
produce great and rapid changes in the temperature. With 
this exception the mean daily variation is very slight, amount- 
ing according to my observations to about 3° per diem during 
the winter months. Immediately after sunset, however, there 
is a very sudden fall of temperature, accompanied, especially 
during certain winds, by so profuse a fall of dew as to render 
it unsafe for the invalid to venture out of doors at this time. 

The mean annual temperature of Malaga is 65°, or 15° higher 
than London, 1° lower than Algiers, 9° higher than Pau, and 
7° lower than Cairo. The mean temperature of winter is 55°, 
or 16° higher than London, exactly the same as Algiers, 13° 
higher than Pau, and 3° lower than Cairo. The mean tempera- 
ture of spring is 68°, or 20° higher than London, 2° higher than 
Algiers, 14° higher than Pau, and 5° lower than Cairo. The 
mean temperature of summer is 78°, or 16° higher than London, 
1° higher than Algiers, 8° higher than Pau, and 7° lower than 
Cairo. And lastly, in autumn the mean temperature of Malaga 
is 60°, or 9° higher than that of London, 2° lower than Algiers, 
2° higher than Pau, and 11° lower than that of Cairo. 

I was indebted to the late Dr Shortcliffe of Malaga for the 
following valuable table, showing the — 



36 



MALAGA. 



Average Temperature at Malaga for a period of Ten 
consecutive Years. 





Mean Temperature. 


Highest Temperature. 


Lowest Temperature. 


Months. 
















8 a.m. 


2 p.m. 


11 p.m. 


8 p.m. 


2 p.m. 


11 p.m. 


8 a.m. 


2 p.m. 


1 p.m. 


January.. 


53-8 


57-5 


531 


59 


62 


57 


50 


53 


48 


February . 


54-6 


57-3 


54-9 


60 


64 


61 


46 


52 


44 


March . . . 


57'8 


60-1 


591 


64 


68 


65 


54 


57 


53 


April 


61-4 


64-2 


60-9 


66 


70 


67 


58 


58 


57 


May 


66*1 


69'1 


64-8 


72 


76 


70 


60 


68 


61 


June 


72-6 


781 


73-8 


76 


79 


78 


71 


71 


70 


July ..... 


76-8 


79-9 


76-1 


80 


85 


79 


75 


77 


73 


August ... 


77-6 


799 


76-9 


80 


86 


81 


74 


78 


75 


September 


72-5 


76-1 


73-8 


79 


84 


77 


69 


75 


69 


October . . . 


66-1 


70-1 


67-5 


74 


76 


74 


60 


63 


60 


November 


59-6 


62-5 


591 


66 


67 


65 


48 


54 


46 


December 


54-8 


58-5 


55-1 


61 


64 


63 


44 


52 


46 



According to my own observations during the winter, the 
mean temperature of the month of December was 59J° ; this 
is calculated upon observations taken at 10 A.M. and 3 p.m. 
each day, and therefore only shows the temperature of the day. 
The mean daily variation between these hours was 2^-°, the 
greatest variation was 5°, and the smallest variation 2°. The 
highest temperature observed was 68°, and the lowest was 52°. 
In January the mean temperature of the month was 57°; the 
highest 61°, and the lowest in the day 50°. The greatest 
variation in the day was 9°, the smallest 2°, and the mean 
daily variation was 3°. During February the mean tempera- 
ture was 58°, the highest temperature 66°; the lowest 50° ; 
the greatest variation in the day 7°, the smallest 2°, and the 
mean daily variation 3£°. 

The annual rain-fall is comparatively small, and the month 
of February is the most rainy period of the year. During the 
three occasions I passed that month in Malaga, the weather 
was generally so wet ami gloomy that invalids were confined 
to their rooms for two-thirds of the time. This rain is usually 
of a tropical character, falling in large drops and with much 



MALAGA. 37 

force. When February has passed, the quantity of rain that 
falls during the rest of the year is very small, amounting on 
an average to 16 inches 5 lines per annum. The total number 
of rainy days observed by Martinez during nine years was 
262, or about 29 days annually, which is 90 days less rain 
than in Pau, 88 less than Eome, 44 less than Madeira, 41 
less than Algiers, 45 less than Nice, and 15 more than at 
Cairo. 

The mountains beyond the Vega almost completely shelter 
the town from the north and west winds. The prevailing 
winds are the east, or levante, which is cold and humid in 
winter, the north-west, and the south-east. 

The north-west wind, or " Terral," is termed un viento fatal. 
It rushes through a gap in the Antequera Mountains, along the 
valley of the Guadalmedina, and arrives in Malaga laden with 
fine sand, which irritates the pulmonary mucous membrane. 
In summer this wind is hot and dry, giving rise to a highly 
irritable state of mind and body. In winter the Terral, 
sweeping down the snow-clad mountains, is intensely cold as 
well as dry. Its ill effects, however, cannot be measured by 
the thermometer alone ; for the force and rapidity of its motion, 
its aridity, and the quantity of impalpable sand it suspends, 
all combine with its low temperature to injure the valetudi- 
narian visitor, who should therefore be forewarned to remain 
within doors as long as this wind prevails, which fortunately 
is seldom more than three consecutive days. 

The connection between defective hygiene and epidemic 
disease has been too well illustrated in Malaga, which has been 
repeatedly devastated by plague, yellow fever, cholera, and other 
zymotics. In the first edition of my work "On Change of 
Climate," I gave a very detailed account from old records of 
no less than twenty-two pestilences, which have almost 
depopulated Malaga at different times between 1493 and 



38 MALAGA. 

1804. The earlier of these appear to have been epidemics of 
genuine oriental plague, while the latter generally assumed the 
form of yellow fever. Of late years these pestilences have not 
returned, but Asiatic cholera has proved very fatal on several 
occasions. 

The prevailing diseases here are fevers, especially the ex- 
anthemata, intermittent, and bilious fevers, acute diseases of 
the air passages, gastric affections, purulent and strumous 
ophthalmia, and elephantiasis arabum, elsewhere so rare in 
Europe, but of which I have seen well-marked instances in 
Malaga, where in one year no less than seven cases of this 
disease were admitted into the civil hospital. 

Senor Martinez Y. Montes, Physician-in-Chief to the Military 
Hospital, has collected tables from which we find, that in 
January the number of deaths was larger than in any other 
month, while in May it was smaller. The total number of 
adult deaths during the year was 9049. The greatest mortality 
from any one disease was 711 from dropsy, and the smallest 
was one death from hydrophobia. Acute and chronic diseases 
of the respiratory organs, not including consumption, were the 
cause of 1208 deaths. The mortality from phthisis was 407, 
more than half of which, or 234, occurred in the civil hospital. 
Cerebral affections are apparently a prolific source of mortality 
here ; 742 fatal cases of these complaints occurred, of which 
no less than 407 are set down to apoplexy .* 

In Malaga the deaths occasioned by consumption among the 
native population are less numerous than in any other European 
southern locality resorted to by invalids in winter. This is, I 
think, a very significant fact; for, as we might naturally 
consider, a place where the mortality from phthisis was very 
great an unsuitable residence for phthisical invalids, so a city 
like Malaga, where the mortality from that disease is remark- 

* Martinez, " Topografia Medica de la Ciudad de Malaga," p. 499. 



MALAGA. 39 

ably small, should be a favourable locality for such patients. 
Its superiority in this respect to our own climate is sufficiently 
proved by the fact, that in this^country 125 deaths out of every 
thousand are caused by consumption, while in Malaga only 34 
deaths per thousand result from that disease. 

When, however, we consider the mortality from all chronic 
diseases of the air-passages, we find the superiority of this 
climate is not so conspicuous as it might at first appear ; for 
the deaths in Malaga from all chronic affections of the respira- 
tory organs are very nearly as great as in London, amounting, 
according to Senor Martinez Y. Montes, to nearly one-ninth 
of the entire number recorded. 

It is a remarkable fact that of late years, ever since this 
town has acquired a renown as a winter residence for phthisi- 
cal patients, the mortality from this disease has increased 
notably amongst the native population. And thus a belief in 
the contagious nature of phthisis has now become so general 
in Malaga, that many Spanish lodging-house proprietors refuse 
to admit phthisical invalids as inmates. This opinion appears 
to have more foundation in fact than is commonly supposed, 
and I cannot doubt that, in hot climates at least, constant 
communication with consumptive patients, and especially 
sleeping in the same room with them, is very likely to prove 
injurious to persons in delicate health, and may determine 
the occurrence of phthisis in individuals who might otherwise 
have escaped this malady. 

The diseases which I have seen • most benefited by the 
climate of Malaga were, consumption in its first stage and 
the cachectic state which immediately precedes the deposition 
of tubercles in the lungs. These cases may sometimes be 
frequently cured, and more commonly the progress of the 
disease may be checked for some time by the action of the 
climate. Cases of chronic bronchitis and humoral asthma in 



40 MALAGA. 

elderly persons occasionally improve materially here ; in other 
instances, however, of a more irritative form of either complaint, 
the climate of Malaga is too tonic or exciting, and may produce 
much injury if improperly resorted to. 

Another class of patients on whom this climate may be 
expected to exert its most favourable influence, are children 
predisposed to, or suffering from, any form of scrofula, whether 
manifesting itself externally by swelling of the lymphatic 
glands of the neck or elsewhere, or seated in the mesentery, or 
assuming those premonitory symptoms which warn us that 
tubercular disease of the lungs is not far ^off, and that nothing 
is wanting but some slight exciting cause to call consumption 
into active existence. In such cases a short residence in the 
dry and tonic atmosphere of Malaga will oftentimes work 
wonders. 

It is quite as important to know what patients should avoid 
any climate as to know what class should select it. Now, con- 
sidering the great mortality from cerebral affections, and par- 
ticularly apoplexy, in Malaga, I think that those predisposed to 
such diseases should not choose this town for their residence. 
Nor would I send a patient suffering from chronic rheumatism, 
or rheumatic arthritis, or neuralgia, to Malaga; as the great 
difference between the temperature of the day and night, and 
the heavy dews that fall after sunset, render this town in such 
cases inferior to other climates, such, for instance, as Western 
Australia, Upper Egypt, and in some cases even Nice. Nor 
can Malaga be advised to dyspeptic and hypochondriacal 
invalids, as the dietary there is not generally suitable for these 
cases. 

The climate of Malaga was considered by the older native 
writers, Don Fernandez Barea, Padre Garcia de la Lena, and 
others to exert a relaxing and unfavourable influence on the con- 
st:' tution of young persons under the age of puberty. But they 



MALAGA, 41 

regarded this locality as an advantageous residence for the 
old, and thought the climate a propitious one for them, 
and calculated, by aiding in the alleviation of the many 
physical annoyances of the aged, to add to the span of their 
existence. 



A 



44 LISBON. 

the churches, defaced the paintings, and sold for waste paper 
most of the valuable libraries of the conventual establishments. 
The only one which escaped, and still exists, is the Irish 
Dominican convent, which is some 200 years old. 

Of late years, since I first visited Lisbon, the sanitary con- 
dition of the city has been much improved. The streets are 
cleaner, the sewerage is better, and in all the principal thorough- 
fares gas has superseded the dim oil lamps that formerly gave 
a faint twinkle through the night. But in the upper and older 
quarters ancient customs still prevail. On my last visit to 
Lisbon I was practically reminded that the old cry of agoa vai, 
" water beware," though not so commonly heard as it was, is 
not yet a thing of the past. On this occasion, returning home 
one dark night, I heard the cry, and had barely time to take 
refuge in an open doorway before the unsavoury shower fell 
close beside me. 

A very short stay will suffice to visit all the sights of Lisbon, 
but an almost inexhaustible fund of beauty and variety will be 
found in the various excursions in the adjacent country ; and 
foremost among these is that to where 

" Cintra's glorious Eden intervenes, 
In variegated maze of mount and glen." 

Cintra is now within an hour's drive from Lisbon by the steam 
tramway. It would be utterly impossible, in the narrow limits 
at my disposal, to attempt any description of the beauties of 
this place, which in summer affords a delightful retreat from the 
intense heat of Lisbon. For most invalids, however, the tran- 
sition would be far too great. Thus, in the middle of June, I 
have found the temperature of Cintra nearly 20° lower than 
that of Lisbon. 

The climate of Lisbon is warm, but humid and variable. 
The mean annual temperature is about 61°; the mean tempera- 
ture of winter is 54° ; spring, 59° ; summer, 68° ; and of autumn, 



LISBON. 45 

59°. The minimum temperature of the year is seldom under 
35°, but occasionally a slight frost occurs during the night in 
December. The maximum annual heat in the sun is towards 
the end of August, when the mercury at 2 p.m. sometimes rises 
to 133°. The extremes of heat and cold annually observed 
differ by between 50° and 60°. 

These thermometrical details are deduced from the scattered 
observations of various native and foreign observers, from 
some tables quoted by Mr Murphy, and especially from two 
papers by Senhor Franzini, in the Transactions of the Eoyal 
Academy of Lisbon * all of which I have tabulated together. 

No sufficient register of the hygrometric state of the atmo- 
sphere has been kept, but it is well known by every observer 
that the air in winter is here laden with vesicular moisture. 
Senhor Franzini states that humid winds predominate over dry 
ones in the proportion of 199 to 165. 

Eain usually falls in heavy showers of brief duration. Thus 
the number of days of settled rain in the year are comparatively 
few, not exceeding 63, while the amount of rain is considerable, 
amounting to upwards of 30 inches annually. One-half of this 
quantity falls in winter, from November to the middle of 
February ; the remainder being nearly equally divided between 
spring and autumn, as there is little or no rain from June to 
October. During the rainy weather the south-west wind is 
prevalent. 

To the stranger recently landed in Lisbon from England, in 
winter, the weather will at first appear by comparison mild 
and genial ; and so indeed it very often is. But still at this 
season cold and damp winds from the westerly points are 
prevalent. And although frost is a rare phenomena in the 

* " Observa?oes Meteorologicas Feitas na Cidade de Lisboa, &c, par Marino 
Miguel Franzini, in Memorias da Acadamia Real Das Sciencias de Lisboa, 
torn. v. p. 92, 125, et torn. vii. p. 61, ad 93. 



44 LISBON. 

the churches, defaced the paintings, and sold for waste paper 
most of the valuable libraries of the conventual establishments. 
The only one which escaped, and still exists, is the Irish 
Dominican convent, which is some 200 years old. 

Of late years, since I first visited Lisbon, the sanitary con- 
dition of the city has been much improved. The streets are 
cleaner, the sewerage is better, and in all the principal thorough- 
fares gas has superseded the dim oil lamps that formerly gave 
a faint twinkle through the night. But in the upper and older 
quarters ancient customs still prevail. On my last visit to 
Lisbon I was practically reminded that the old cry of agoa vai, 
" water beware," though not so commonly heard as it was, is 
not yet a thing of the past. On this occasion, returning home 
one dark night, I heard the cry, and had barely time to take 
refuge in an open doorway before the unsavoury shower fell 
close beside me. 

A very short stay will suffice to visit all the sights of Lisbon, 
but an almost inexhaustible fund of beauty and variety will be 
found in the various excursions in the adjacent country ; and 
foremost among these is that to where 

" Cintra's glorious Eden intervenes, 
In variegated maze of mount and glen." 

Cintra is now within an hour's drive from Lisbon by the steam 
tramway. It would be utterly impossible, in the narrow limits 
at my disposal, to attempt any description of the beauties of 
this place, which in summer affords a delightful retreat from the 
intense heat of Lisbon. For most invalids, however, the tran- 
sition would be far too great. Thus, in the middle of June, I 
have found the temperature of Cintra nearly 20° lower than 
that of Lisbon. 

The climate of Lisbon is warm, but humid and variable. 
The mean annual temperature is about 61°; the mean tempera- 
ture of winter is 54° ; spring, 59° ; summer, 68° ; and of autumn, 



LISBON. 45 

59°. The minimum temperature of the year is seldom under 
35°, but occasionally a slight frost occurs during the night in 
December. The maximum annual heat in the sun is towards 
the end of August, when the mercury at 2 p.m. sometimes rises 
to 133°. The extremes of heat and cold annually observed 
differ by between 50° and 60°. 

These thermometrical details are deduced from the scattered 
observations of various native and foreign observers, from 
some tables quoted by Mr Murphy, and especially from two 
papers by Senhor Franzini, in the Transactions of the Eoyal 
Academy of Lisbon * all of which I have tabulated together. 

No sufficient register of the hygrometric state of the atmo- 
sphere has been kept, but it is well known by every observer 
that the air in winter is here laden with vesicular moisture. 
Senhor Franzini states that humid winds predominate over dry 
ones in the proportion of 199 to 165. 

Eain usually falls in heavy showers of brief duration. Thus 
the number of days of settled rain in the year are comparatively 
few, not exceeding 63, while the amount of rain is considerable, 
amounting to upwards of 30 inches annually. One-half of this 
quantity falls in winter, from November to the middle of 
February ; the remainder being nearly equally divided between 
spring and autumn, as there is little or no rain from June to 
October. During the rainy weather the south-west wind is 
prevalent. 

To the stranger recently landed in Lisbon from England, in 
winter, the weather will at first appear by comparison mild 
and genial ; and so indeed it very often is. But still at this 
season cold and damp winds from the westerly points are 
prevalent. And although frost is a rare phenomena in the 

* " Observa$oes Meteorologicas Feitas na Cidade de Lisboa, &c, par Marino 
Miguel Franzini, in Memorias da Acadamia Real Das Sciencias de Lisboa, 
torn. v. p. -92, 125, et torn. vii. p. 61, ad 93. 



i 



46 LISBON. 

town, yet the nights in the large fireless rooms of Lisbon are 
often chilly and uncomfortable, and I have more than once 
seen entire families muffled up to the eyebrows in every 
procurable wrapper, cloak, and even blanket, shivering over 
the brazeiro. But such weather is an exception to the usual 
mildness of the winters, the temperature of which, though 
much below that of several other health resorts, is, however, 
ordinarily fully as many degrees higher than in the most 
favoured of our home winter climates. In spring, however, 
cold winds, accompanied with a very hot sun, are prevalent. 

Of late years Lisbon has been little resorted to as a winter 
residence by British invalids, although formerly it was one of 
the most frequented of these places. 

Among the diseases to which the climate of Lisbon appears 
applicable, may be included chronic winter cough with in- 
creased sensibility, and permanent sub-inflammatory condi- 
tion of the pulmonary mucous membrane. This state, how- 
ever, will demand a very careful diagnosis, bearing in mind 
those forms of phthisis in which the climate would prove 
injurious. Dyspepsia, attended by a similar state of the mucous 
membrane of the stomach, will sometimes be cured by a change 
from England to Libson. 

That the climate of Lisbon acts unfavourably on the physical 
development and constitution of young persons, is, I think, 
established by the stunted and prematurely aged appearance 
of the Portuguese children after the age of fourteen. Up to 
this period they thrive equally well, and even grow faster 
than do children in this country, but once passed that age their 
growth becomes arrested, and their carriage and aspect are 
those of old men, before they attain puberty. 

In some measure, however, this must result from the excess 
to which smoking is carried, even by young children. I have 
often seen, with astonishment, boys whose age could not have 



LISBON. 47 

exceeded six or seven years, gravely sucking a strong cigar, 
with apparently the same gusto which our less precocious 
infants derive from the forbidden delights of the sugarstick. 
There can be no doubt that the influence of the nicotin thus 
absorbed must be most injurious at this tender age. But even 
irrespective of this, it would seem that the climate is unpro- 
pitious to youth. 



48 MADEIRA. 



CHAPTEE VII. 

MADEIRA. 

A few years ago Madeira was par excellence the winter resort 
of English consumptive patients. Now, however, this island 
is comparatively deserted by such persons, and having been 
formerly recommended in cases in which it was not suitable, 
has now come to be almost disused even where it might be 
serviceable. Moreover, the tide of fashion, which influences the 
choice of health resorts so largely, has for the present set in 
other directions. The remoteness and comparative inacces- 
sibility of this island, thirteen hundred miles from the nearest 
English port, has also conduced to the preference now generally 
given to nearer winter resorts. 

From Southampton or Liverpool, Madeira may be reached in 
about eight days by the steamers of the African, Union, or 
Brazilian Mail Companies. 

A remarkable illustration of the vague manner in which 
health resorts are sometimes recommended may be found in 
the last edition of Dr Constantine James' work on this subject, 
in which he speaks of Madeira as the "Type des climats 
d'hiver," * without distinguishing the fact that it is the type 
only of one class of climates, by no means generally applicable 
for pulmonary invalids. 

* "Guide Fractique des Eaux Minerales et aux Stations Hivernales," par 
le Dr Constantine James, IXrae edition, p. 573, Paris, 1875. 



MADEIRA. 



49 



Of all the climates described in this work, that of Madeira 
is unquestionably the most equable. Thus, during winter and 
spring, the mean range of temperature observed at Funchal was 
only 15° in the twenty-four hours, whilst in Upper Egypt there 
is an average range of 40° during these seasons. But still the 
latter place is incomparably better suited for the majority of 
phthisical invalids than the former, the atmosphere of Upper 
Egypt being very dry and tonic, whilst that of Madeira is 
essentially humid, and in many instances relaxing. 

The extreme humidity of this climate is shown by the 
impossibility of keeping steel instruments free from rust, or of 
preserving any musical instrument in tune, or any article of 
clothing, however carefully packed, from being injured by the 
dampness of the air; as well as by the exuberant tropical 
vegetation, which attracts the admiration of every visitor to this 
island, and which, as rain falls only in small quantities, and at 
very long intervals, must be maintained by the excessive 
humidity of the atmosphere. 

The mean annual temperature of Funchal is 66 0, 93, and 
according to Dr Mason's observations,* the minimum external 
temperature was 57° in January, and the maximum was 83° 
during the prevalence of the hot African " Leste " wind in June. 
Independently of this wind the maximum day temperature 
was 79° in August. 

External Temperature, Funchal, Madeira* 





Mean 
Maximum Tem- 
perature in 
the day. 


Mean 
Minimum Tem- 
perature in 
the night. 


Mean Daily- 
Range. 


Mean Range 
of the Twenty- 
four hours. 


"Winter, 
Spring, 
Summer, . 
Autumn, . 


68-66 
74-59 
80-00 
76-33 


55-00 

57-50 
66-00 
61-66 


7-60 
9-50 
8-67 
8-33 


13-66 
17-00 
15-00 
14-67 


Year, 


74-87 


59-79 


8-54 


15-08 



* "A Treatise on the Climate and Meteorology of Madeira," by the late J. A. 
Mason, M.D., p. 183. 



50 MADEIRA. 

The prevailing wind in Madeira is the north-east, except at 
Funchal, where, owing to the position of the adjoining moun- 
tains, southerly and south-west winds are more frequent. 
Throughout the island generally, land and sea breezes alternate 
regularly, and mark the changes of the seasons by the order in 
which they occur, the one prevailing during the night, 
and the other from sunrise until evening. In summer the 
" Leste " wind from the African coast occurs periodically for a 
few days, and is very similar to the " Terral " of Malaga, or the 
" Khamsin " wind of Cairo, being not only intensely hot and 
dry, but also laden with impalpable sand, and most irritating 
to the lungs and injurious in its general effects. 

It has been proved that " the inhabitants of Madeira are not 
remarkable for longevity, but, on the contrary, in general die 
very young ; " and though this fact has been explained in 
various ways, it is nevertheless a strong a priori argument 
against this island as a health resort. Amongst the prevail- 
ing diseases of Madeira, consumption must be included; but 
whether the prevalence of this disease amongst the native 
population is to be ascribed to the climate, or to the unfavour- 
able hygienic condition and meagre diet of the poorer classes, 
has long been a disputed question. The results of the experi- 
ment made a few years ago by the authorities of the Brompton 
Hospital were by no means favourable to the reputation of 
Madeira as a health resort for the consumptive. Twenty-six 
carefully-selected cases of phthisis were sent to winter in 
Madeira ; of these only two were decidedly improved, seven 
were slightly improved, one died from haemoptysis, five re-, 
turned worse than when they left home, and in twelve cases 
no alteration could be observed in the patients' condition. 

The cases in which a winter visit to Madeira might prove 
serviceable are — in dry chronic bronchitis and winter cough, 
with great irritability of the mucous membrane of the air 



TENERIFFE AND ST MICHAELS. 51 

passages and little expectoration ; chronic laryngeal irritation, 
and cases of spasmodic asthma of the same character ; and 
also, with more caution, in a limited number of cases of 
phthisis in its earliest stage, and marked by similar symptoms. 
But to the majority of consumptive patients, especially if the 
disease be advanced beyond the first stage, the humid, warm, 
and relaxing atmosphere of Madeira would, I believe, be pre- 
judicial. 

The foregoing account of the climate of Madeira might, with 
very little alteration, be applied to two other groups of not 
far distant islands, also situated in the North Eastern 
Atlantic Ocean, and which have been as deservedly recom- 
mended as health resorts in the same class of cases as Madeira. 
viz., the Canaries and the Azores. Some years ago I had an 
opportunity of visiting both these groups. The best known 
of the Canaries — Teneriffe — lies some two hundred and fifty 
miles to the south of Madeira, and is only sixty miles distant 
from the African coast. This island, the circumference of 
which is less than a hundred and fifty miles, has been so often 
described by tourists, and is now so little visited by health- 
travellers, as to render any detailed account superfluous. The 
voyage by steam from Liverpool to Teneriffe varies from eight 
to ten days, and costs about twenty pounds. There is pretty 
good hotel accommodation at Santa Crux, the capital of the 
Island. The mean annual temperature of this town is 6° 
higher than that of Funchal. But the climate is much less 
equable than that of Madeira ; thus, according to Sir James 
Clark, the difference between the mean temperature of the 
winter and summer at Funchal is nine degrees, whilst at 
Santa Crux it amounts to twelve degrees. The mean annual 
temperature is 71° ; that of- winter 65°; spring, 69° ; summer, 
77° ; and autumn, 74°. The annual rainfall is somewhat less 
than that of Madeira, nor is the atmosphere quite so humid 



52 TENERIFFE AND ST MICHAELS. 

and relaxing. But its proximity to the African coast exposes 
this island to harsh dry easterly "winds from the Lybian 
deserts ; and, moreover, the distance from England, and com- 
parative deficiency of hotel accommodation and resources for 
foreign visitors, render this island still less adapted as a 
health resort for British pulmonary invalids. 

The Azores being two hundred and fifty miles to the north- 
west of Madeira, enjoy a cooler but more humid, relax- 
ing, and equable climate than that sanatorium. The prin- 
cipal of these islands as a health resort is St Michael's, the 
mean annual temperature of which is five degrees lower than 
that of Funchal ; and that of winter two degrees under that of 
the latter town. The prevailing winds in St Michael's are 
northerly and easterly ; the annual rainfall is about thirty 
inches, and the atmosphere is still more saturated with 
moisture than that of Madeira. I need not dwell further on 
the climate, which, although one of the warmest and most 
equable in the world, is far too relaxing for the great majority 
of pulmonary sufferers, though it might advantageously be 
employed in some cases of spasmodic asthma, dry chronic 
bronchitis, and laryngeal irritation, were it not for the disad- 
vantages of a health resort so remote, difficult of access, and 
unprovided with many of those comforts and resources which 
are regarded as indispensable by invalids. 



ALGIERS. 53 



CHAPTER VIII. 

ALGIERS. 

Few of the ordinary winter resorts of invalids are more easily 
approached from England than Algiers, as there are regular 
departures from Marseilles every second day, for that city, by 
the steamers of the " Messageries Maritimes " and those of the 
" Compagnie Valery." This voyage, in fair weather, and 
under ordinary circumstances, is a mere pleasure excursion, 
occupying from thirty-six to forty hours. 

The first view of Algiers from the bay is very picturesque ; 
from the water's edge a triangle of houses extend to the top of 
the hill, the apex being crowned by the ancient fortress of the 
" Casbah," the last refuge of the Deys. The snow-white walls 
of the city glistening under an African sky, the lofty minarets 
still surmounted by the crescent, the grave turbaned figures 
we see loitering about the mole, — all give an oriental character 
to the scene. 

There is a wide choice of hotels, of which the best seemed to 
us, after having tried others, the Hotel d'Europe, where we 
remained the greatest part of our stay in Algiers. The usual 
charge in all of them is from twelve to fifteen francs a-day, 
including breakfast, dinner, and apartments. 

The markets are well supplied, and the prices are somewhat 
less than in this country, but the meat is not equal to ours. 
Fruit is abundant; and as a proof of the mildness of the 



54 ALGIERS. 

climate, I may mention that during December we had green 
peas and fresh strawberries, grown in the open air, almost 
every day at dinner. 

The streets in the higher quarters of the city still retain 
their oriental aspect to a remarkable extent, being tortuous, 
dirty, and so narrow that in many two horsemen can with 
great difficulty pass each other. When a string of donkeys 
laden with projecting sacks appears in one of these lanes, 
all the passers-by are forced to retreat into the nearest door- 
way, and woe betide the luckless individual who fails to 
secure this timely shelter. 

In the modern part of the city, near the port, the streets are 
wide, well paved, and kept perfectly clean. Nearly all these 
communicate with the Place du Gouvernement, which over- 
looks the harbour, and around which most of the hotels and 
cafes are situated. The chief thoroughfares, such as the Bab- 
el -Oued and its continuation, the Eue Bab-Azoun, the Rue de 
Chartres, &c, are well lighted with gas, and contain shops that 
would not discredit Paris itself. All these streets are built 
with arcades overhanging the footpaths, and thus a dry walk, 
in wet weather, and a cool retreat from the scorching sun in 
summer, is secured. By invalids, however, these colonnades, 
in which even on the hottest day there is always a cold 
draught, should be carefully avoided, and are most injurious. 

In the way of amusements there is little to tempt the 
stranger, and even the gay and mercurial French seem to be 
easily affected by the hot Algerian climate. They soon become 
bilious and gloomy, and appear to consider only how they 
may most quickly amass sufficient means to enable them to 
leave the colony and return to France. A large and handsome 
theatre has, however, been erected in the Place Bresson, but is 
very poorly supported. 

One of the chief advantages of Algiers consists in the 



ALGIERS. 



55 



number of opportunities for agreeable excursions from the 
town, and the beauty and variety of these. 

To antiquaries Algiers presents an almost virgin field of 
research and discovery ; rich in monuments of Carthaginian 
and Eoman antiquity, and in remains, too, of a date long 
antecedent to either. A paper on some of these, read before 
the Eoyal Irish Academy, by my father, Dr E. E. Madden, 
contains, I believe, the first account given of " The Dolmens of 
Bainam." 

According to M. de Pietra Santa, the mean annual tem- 
perature of Algiers is 66°. The mean temperature of winter 
is 55°; spring, 66°; summer, 77°; and autumn, 62°. During a 
period of seven years, Dr Armand * tells us that the thermo- 
meter only once fell to zero. 

In considering the climatology of Algiers, I have adapted 
Dr Armand's division of the year into two seasons, the first 
that of the rains, commencing in November and terminating 
at the end of April, and the second that of the heats, which 
endures from May to October, inclusively. 

Temperature of the Coast of Algeria during the cool and 
vjet season. 





Maximum. 


Minimum. 


Mean. 







o 





November, 


68 


57 


63 


December, 


60 


50 


55 


January, . 


60 


50 


55 


February, . 


54 


46 


50 


March, 


64 


55 


58 


April, 


70 


58 


64 



During these months snow falls in considerable quantities 
on the mountains, at the height of 500 metres above the level 
of the sea. Snow very rarely falls in the valleys along the 



L Algerie Medical, " p. 49. 



56 AL&IEKS. 

coast, and when it does fall, generally thaws as soon as it 
touches the ground. 

The effects of the extreme cold of the African mountains 
were dreadfully experienced by the French troops at the 
retreat of Constantine, which, according to Dr Armand, a 
physician attached to the French army, " resembled on a small 
scale the horrors of the retreat from Eussia. The column of 
Setif, on the 2d and 3d of January, were assailed and dispersed 
by a snow-storm in the mountains of Bou-Taleb, and entered 
Setif on the 4th, with 532 cases of partial congelations of the 
extremities, and leaving 208 dead on the road." * 

During the month of December, the thermometer in the 
open air and in the shade, in a westerly aspect, was very 
carefully observed by me in Algiers at regular times, twice 
daily, and also at various hours between 4 a.m. and 11 P.M. 
At no period of the day did the heat ever exceed 68J°. The 
mean temperature at noon during the month was 66°. The 
mean temperature of the night was 58£°, and the lowest tem- 
perature observed at any period of the day or night was on 
Christmas day at 4 A.M., when the temperature was 56°, and 
at noon was only 60°. The mean variation up to the 24th 
was 7i°, and the greatest variation during the twenty-four 
hours was on the 14th December, when the temperature at 
noon was 68|-°, and at 8 p.m. had fallen to 59°, being a varia- 
tion of 9 J°. 

In 1738 Dr Shaw, who for twelve years, while chaplain to 
the English .Factory, kept a very accurate meteorological 
register at Algiers, tells us that the average annual rain-fall 
was 27 or 28 inches.-f- It would seem from this that the 
climate had become damper since his time, for, according to 
nearly all the modern observers, the annual rain-fall now 

' * "L'Algerie Medical," p. 42. 
t Shaw's " Travels," Oxford, 1738, folio, p. 218. { 



ALGIEES. 57 

amounts to close on 32 inches, and the average number of 
rainy days in the year is from 55 to 60. 

Six-sevenths of the annual rain-fall, and seven-eighths of 
the total annual number of rainy days, occur between 
November and April inclusively. These rains occasionally 
give rise to veritable inundations. Fortunately, however, these 
are seldom very serious, and the floods oftentimes prove bene- 
ficial in their after effects, fertilising lands that would other- 
wise be parched up into a barren desert. 

In summer, notwithstanding the sea-breeze which generally 
prevails along the coast, the thermometer attains a height 
unknown in any part of Europe, accompanied by a sultry 
stillness of the air, destructive to vegetation and injurious to 
animal existence. Such was the weather which the poet 
Campbell, in his epistle to Horace Smith, alludes to — 

"Dear Horace ! be melted to tears, 
For I'm melting with heat as I rhyme ; 
Though the name of this place is All-jeers 
'Tis no joke to fall in with its clime." 

The hygrometric state of the air differs materially in the 
lowlands and mountain districts, being generally dry in 
elevated places ; while in the valleys the atmosphere during 
the night is saturated with moisture, giving rise to damp and 
foggy weather, which, occurring after the intense heat of the 
day, occasions much mischief, and partially explains how it is 
that fever is endemic in some localities. 

Westerly winds are most prevalent in Algiers. Those of the 
east are next in frequency, and are generally attended with 
broken weather and cold mists. 

At all seasons the temperature of this place is subject to 
great and sudden changes. Profuse dew falls at night, and 
the atmosphere after sunset becomes loaded with moisture. 
For this reason it is never safe for valetudinarians to be 



58 ALGIEKS. 

abroad before the sun has some power in the morning, nor 
after sunset at all. Exposure to the night air is not only 
dangerous to European invalids, but prejudicial to persons in 
health. 

Throughout the whole of Algeria there is a great tendency 
to febrile affections, though they are less common in the city 
of Algiers and the adjacent villages than in any other part of 
the colony. Wherever there are marshes, or lakes, or when soil, 
not previously cultivated, has been cleared for the first time, 
there intermittent fevers prevail. In chronic cases a remark- 
able enlargement of the spleen takes place, that organ, as I 
have seen in several instances in the civil hospital of Algiers, 
apparently occupying nearly the entire abdominal cavity. 
These fievres paludeens, have been the bane of Algeria, and 
owing to this cause the population has in some localities been 
renewed three times since the Erench colonization. This 
tendency to malarial fever renders great caution necessary on 
the part of invalid visitors. I myself suffered from a severe 
attack of this kind, following fatigue and exposure to the sun 
during a short excursion on the verge of the desert. This 
assumed an intermittent type, and, even long after my depar- 
ture from the colony, recurred again and again on the slightest 
exciting cause. 

The Algerian climate is very fatal to European children 
between the age of six months and two years ; the mortality 
at this period of life, according to Drs Eoley and Martin, 
authors of an official work intended to encourage emigration 
to the colony, amounting to 440 per 1000, or nearly one-half. 
" This," they justly observe, " is enormous, and indicates the 
almost impossibility of rearing in Africa European children, 
who have been brought over during dentition."* 

* "Histoire Statistique de la Colonisation, Algerienne au Point de vue du 
Peuplement et de L'Hygiene," p. 107. 



ALGIEKS. 59 

From the same valuable work we also learn how greatly 
the death-rate of this colony exceeds that of the mother 
country. 

Affections of the eyes, especially scrofulous ophthalmia, are 
common, and so is scrofula in all its forms. In the civil 
hospital at Mustapha, the physician pointed out to me several 
well-marked cases of scrofulous disease of the bones. He 
accounted for the prevalence of this malady by the very poor 
food on which the lower class of the natives subsist, and partly, 
also, by the crowded state and defective ventilation of their 
dwellings. 

It has long been a disputed question whether pulmonary 
consumption is prevalent in Algeria or not ; and also whether 
this climate is a suitable one as a health resort for the phthi- 
sical, or the contrary. Nearly forty years ago, when this 
matter was brought under the consideration of the French 
Academy of Medicine, it was declared that — " it was doubtful 
if the climate of Algiers was favourable to the cure of con- 
sumption ; "* and even at the present time little more can be 
said. 

The prevalence of scrofula supports the statement of Drs 
Armand,-(- Deleau, and Laveran,j physicians of the French 
army in Algeria, that phthisis is common among the native 
Arabs. This opinion is also maintained by the Tebibs, or 
native doctors, who, moreover, believe phthisis to be conta- 
gious. 

Many writers, however, consider that consumption is all 
but unknown in Algeria, and that, when it does occur, it is 
only the development of disease existing before arrival in the 
colony, or inherited from phthisical parents. Dr Odrultz,§ 

* "Bulletin de L'Academie Royal de Medicine," 1836, vol. i. p. 43, &c. 

t " L'Algerie Medical," p. 375. 

i " Memoires de Med. Milit." t. lii. 

§ " Annuaire Therapeutique de M. Bouchardat. " 



X 



60 ALGIERS. 

Dr Bodichon,* Dr De Pietra Santa,-)- Dr Feuillet^ and some 
other recent writers support this opinion. 

From what I saw myself during my stay in Algiers, I have 
no doubt that consumption is by no means unfrequent amongst 
the resident population, although it is less common than in 
England or France, and that other diseases of the respiratory 
organs are prevalent in this colony. Thus, out of five hundred 
and forty patients in the civil hospital of Algiers when I visited 
it, no less than fifty were pulmonary cases. And I believe 
that unless great precaution be observed by invalid visitors to 
Algiers, in their dress, mode of living, and above all in the 
careful avoidance of exposure to the night air and cold winds, 
and a constant recollection of the remarkable difference of 
temperature which exists between the sun and shade, this 
climate is a hazardous one for persons suffering from pulmon- 
ary complaints. 

Cases of phthisis, accompanied with hectic sweats, are often 
aggravated here, and I have heard invalids complaining that 
their night perspirations, which had been controlled by change 
of air in the journey from England, again returned after a few 
days' residence in Algiers. 

Eor a patient in the third stage of consumption it would be 
difficult to select a more unsuitable climate than this, or one 
where the disorganization of the pulmonary structure and 
death of the patient would be more likely to be accelerated. 

Some cases of chronic bronchitis derive remarkable benefit 
from the climate of Algiers. Several instances fell under my 
observation of elderly persons suffering from this disease, and 
from senile catarrh, who here regained, to an unexpected 
extent, their general health, after having gone the rounds of 

* " Algeria as a Winter Residence for the Efiglish," p. 44. 

+ "Journal of Practical Medicine and Surgery," vol. xxxi. No. 10, p. 469. 

$ " De La Phthisic Pulraonaire en Algerie," 2d edition, p. 15. 



ALGIERS. 61 

all the wintering places in the south of France and Italy 
without any amelioration. But other cases of the same disease 
have also come under my notice, in which, the climate of 
Algiers having proved ineffectual or injurious, Malaga was suc- 
cessfully resorted to. 



62 MOROCCO. 



CHAPTEE IX. 

MOEOCCO. 

Within four hours' sail of Gibraltar, with which there is 
almost daily communication by steamer, is an empire almost 
as large as Spain, no small part of which is blessed with a 
most genial climate, and possesses the most fertile soil in the 
world. Extending from the Atlantic on the west, to Algeria 
on the east, and from the Mediterranean stretching far into 
the Great Sahara on the south, Morocco includes a territory 
of upwards of 150,000 square miles, a considerable part of 
which is to this day almost a terra incognita. 

The following brief account of my visit to Morocco may 
perhaps serve to direct the attention of others to this climate, 
and its possible therapeutic influences : — Arriving at Tangiers 
by steamer from Gibraltar, the town was not seen until we 
were close to the land, as, although built on a hill, the houses 
are for the most part flat-roofed and low. This hill is 
surmounted by an old Moorish Casbah or castle, whose 
dilapidated white- washed walls would make a poor defence 
against modern artillery. Below this rises the lofty minaret 
of the Jamaa Kiber, or principal mosque, while nearer the 
port the forest of masts made it appear in the distance as if 
some crowded dock was placed there. These, however, were 
but the flag-staffs of the various consuls, who each deem it a 
point of national honour to have a taller pole than their 



MOROCCO. 63 

neighbours. All this presented such a contrast to the place 
we had just left, that it was difficult to imagine that Gibraltar 
was only thirty-eight miles distant. The steamer was forced 
to anchor a long distance from the land, as the port was 
destroyed when the English evacuated Tangiers in 1684, and 
has never been restored since. 

The town is surrounded by semi-ruinous walls, passing 
through which we entered the main street; this traverses the 
city from east to west, and is tolerably wide and clean, 
containing the principal shops and bazaars, as well as the 
Jamaa Kebir, or great mosque, a large, but very ugly, brick 
building, a little above which the street expands into the 
market-place. 

There are some four or five hotels in Tangiers. These for 
the most part are comfortable and very moderate ; thus in the 
best of these we lived very well for rather less than seven 
shillings a day. 

While we were in Tangiers the annual caravan of Hadjis, or 
pilgrims to Mecca, arrived from the interior, and remained here 
for some days, waiting for the steamers by which they were to 
perform their voyage to the East. Amongst these pilgrims 
were men of every hue, from the perfectly white and dignified 
Moor of El-Garb, clad in a rich and most becoming costume, 
to the jet black native of Soudan, whose only clothing was a 
narrow cloth around the loins, and perhaps a ragged blanket 
thrown loosely over one shoulder. 

In the encampment of these Hadjis, outside the walls of 
Tangiers, we witnessed a most extraordinary performance. 
In the centre of a great crowd of Hadjis were a party of four 
or five negroes, dancing and screaming to the music of a kind 
of rude tambourine. Suddenly the music, if the noise could 
be so called, stopped for a minute, and one of the per- 
formers came forward holding a stick, to the end of which a 



64 MOEOCCO. 

large clasp-knife was fastened in one hand, and having in 
the other a cannon ball, weighing about ten or twelve pounds ; 
which was handed round and examined by several of our party. 
The dancing and shouting recommenced, and the actors gradu- 
ally worked themselves into a state of extreme excitement ; the 
chief now sat down in the centre of the ring, and poising the 
ball in his right hand, threw it by a powerful effort several 
feet into the air, and stooping forward received it in a slanting 
direction on the upper part of the frontal bone, the force of 
the blow producing a dull sound which was distinctly heard 
by every one in the circle; and the blood, now oozing in 
streams from the bare scalp, covered the man's whole face. 
After rushing round and round, singing and dancing for some 
moments, he repeated the same thing three or four times, and 
then fell senseless to the ground ; the others dancing about 
him until he came to, when he at once commenced cutting 
himself about the head and face, with the knife I have before 
mentioned, and then, when his features were so gashed and 
disfigured as to be hardly discernible, he threw himself down 
and remained lying on his face, biting the earth until I came 
away, one of the performers meanwhile going about soliciting 
money, of which he got very little. Close by was a rival 
exhibition of snake-charmers, who were freely handling large 
serpents. 

How the first of these feats was accomplished I am utterly 
unable to explain, for had the same blow been given to any 
European cranium, I have no doubt that a depressed fracture 
would have been the result; and even supposing that this 
negro's skull was of sufficient thickness to sustain the force of 
such a blow without serious mischief, I cannot conceive how 
the repeated shock of so great a concussion could have been 
borne without occasioning fatal injury to the brain. 

The environs of Tangiers are interesting, especially the cliffs 



MOROCCO, 65 

on the west of the town, which command a very extensive 
and beautiful view of the straits and Spanish coast from 
Trafalgar to Gibraltar. Here the outlines of old English 
batteries may still be traced ; and half -buried in the sand we 
found several rust-consumed cannon, stamped with the 
English arms of the time of Charles II. On the south side of 
the city ruins of a very remote antiquity are discernible ; 
these are supposed to have belonged to the ancient Tingis; 
and in the same neighbourhood several of the arches of an 
extremely graceful Eoman bridge stand in tolerable preserva- 
tion. Outside the land gate is the SoJc-el-ivahad, where the 
principal market is held every Sunday; beyond is the 
neglected and ill-kept cemetery, above which, on the hill, is a 
white bee-hive shaped coubba or Santon's tomb. 

The natural history of northern Morocco differs little from 
that of Andalusia, the only difference perceptible being that 
the soil in Barbary is far more productive than it is on the 
other side of the straits, although the cultivation is of the 
rudest kind. In the province of El-Garb two crops in the 
year are of ordinary occurrence, and Gibraltar depends en- 
tirely on Morocco for its excellent supply of oranges, lemons, 
grapes, figs, melons, and dates, which are all sold here at 
fabulously cheap prices. 

No very accurate details of the climate have, I believe, been 
yet published. During my stay in spring the weather was 
mild and genial, and at mid-day was even too hot for much 
exercise. The position of the town, however, exposes it com- 
pletely to the cold damp winds, which rush through the 
funnel-shaped straits from the Atlantic, while its aspect, 
being open to the east, must render it even more subject to 
this wind than Gibraltar ' is. The annual rainfall is about 
thirty inches, which, as in most parts of Africa, principally 
occurs at one season, during the months of October and 

E 



66 MOKOCCO. 

November. The rains being succeeded by great heat, vegeta- 
tion is consequently rapid and early; thus in January the 
fields are already covered with flowers, and in March the 
barley crop is reaped. Though the climate is hot it is not 
parched or arid, as the province of El-Garb is protected by the 
interposition of the two ranges of the greater and lesser Atlas 
mountains on the south and south-east from the hot winds of 
the desert. Its proximity to the Mediterranean and Atlantic 
on the north and west also modifies the temperature, which 
in this province seldom falls below 40° in winter, or rises 
above 86° in summer. 

From the climate we next come to examine the diseases to 
which it gives rise. Ophthalmia is very prevalent in Tangiers ; 
so is catarrh, especially in the Jewish quarter, where many 
of the inhabitants present a pallid, unhealthy, and even 
phthisical appearance. Elephantiasis Arabum is common, and 
I have seen a mendicant outside the gate of Tangiers exhibit- 
ing a leg enlarged by this disease to nearly three times the 
size of its fellow. 

Mr Jackson, who resided for sixteen years in the Barbary 
States, asserts that leprosy, called Murd Jeddem, is endemic 
throughout Morocco ; * and Mr Lempriere says that " the 
leprous affection appears to be hereditary, and has the appear- 
ance of being the true leprosy of the ancients. It breaks out 
in great blotches over the whole body, in some few forming 
one continual sore, which frequently heals up, and at stated 
times breaks out afresh, but is never thoroughly cured." f 
Constitutional syphilis, or Murd Kibeer, is remarkably wide- 
spread throughout this country, and the true Oriental plague 
has repeatedly almost depopulated Morocco. 

* "An Account of the Empire of Morocco," &c, p. 154. 
t "A Tour from Gibraltar to Morocco," by William Lempriere, Surgeon, p. 
9, 2d edition. 



MOROCCO. 67 

To this long catalogue of ills must be added every form of 
scrofulous disease, and during the stay of the Hadj in Tangiers 
I had an opportunity of observing the number of persons 
evidently of the strumous diathesis who were here collected 
together from every part of the empire. This must, to some 
extent, be attributable to the utter neglect of hygiene and 
poverty of diet of the lower classes. But still, the mere 
prevalence of scrofula in any country from whatever cause it 
may arise, should make us most cautious in selecting that 
place as a health resort for the consumptive. 

I have not, however, had sufficient personal experience of 
this climate, in affections of the respiratory organs, to enable 
me to speak absolutely of its action in these cases. Several 
invalids who were of our party seemed to derive benefit from 
their stay in Tangiers; this, however, was probably owing 
to the superiority ' of the living here to that of Malaga, where 
they had been spending the winter. For the same reason I 
think that invalids suffering from dyspepsia and hypochon- 
driasis, and possibly persons in whom climacteric disease has 
begun to manifest itself, as well as that large class of whom I 
have treated in the beginning of this work, namely, valetudin- 
arians, not actually ill, but whose state is best described by 
the vague term, " out of health," may in some cases derive 
advantage from a short visit to Tangiers. 

At right angles to, and j only fourteen miles distant from, 
Gibraltar, stands its formidable rival, the Spanish key of the 
Mediterranean — Ceuta, which, like Gibraltar, is built on a 
rocky peninsula jutting out into the straits, of which it forms 
the south-eastern point. This peninsula, nearly three miles 
in length, terminates in the bold headland of El Minah, and 
is formed by seven hills. One of these mountains, now known 
as Mount Hacho, is supposed to be the Abyla, or southern 
pillar of Hercules. 



68 MOEOCCO. 

In most respects Ceuta resembles its opposite neighbour, its 
situation beingvery similar, being, like it, a small, strongly- 
fortified town and convict settlement in a foreign land, and, 
notwithstanding its extreme antiquity, is almost as destitute of 
any object of interest within its walls. The environs, however, 
are strikingly beautiful and wonderfully fertile, producing ex- 
cellent oranges, as well as figs, melons, grapes, and sugar-cane. 

The climate of Ceuta differs little from that of Gibraltar, 
although somewhat warmer and better sheltered from cold, 
harsh winds. In this respect it is also more advantageously 
situated than Tangiers. 

Tetuan or Tetawan is about twenty-five miles south of 
Ceuta, and is nearly four miles inland. It was formerly a 
place of some importance, but has now fallen into decay and 
ruin. The environs are highly cultivated, however, and pro- 
duce the finest fruit in the world. 

The climate is similar to that of Tangiers, though in one 
respect superior to it, being in a great measure sheltered 
from the damp winds to which that place is exposed. It 
would, however, be impracticable for any invalid to remain in 
this town, from the total want of all the conveniences of life, 
as well as from the difficulty, not to say danger, of living 
amongst an uncivilised and fanatical Mahometan population, 
who regard all Europeans with contempt and aversion. The 
same observation applies equally to the much superior climate 
of El Araiche, a very ancient Moorish town, situated just 
within the mouth of the river Kos, about forty-five miles 
south of Cape Spartal, which may be reached by a journey of 
a day and a half from Tangiers, and which has also been recom- 
mended as a winter residence for invalids ; but on account of 
the greater difficulty of access, and total want of accommoda- 
tion, is still more unsuitable as a health resort for European 
valetudinarians. 



PAIL 69 



CHAPTER X. 

PAU, ARCACHON, AND BIARRITZ. 

With one exception, the most frequented winter health resort 
in Europe is Pau. In the following chapter, founded on my 
own experience during two visits at long intervals, I shall 
endeavour to enable the reader to judge whether the reputation 
which each year attracts so large a number of British invalids 
to this place is well founded or not. 

Pau, the ancient capital of Beam and Navarre, which may 
be reached in eighteen hours by train from Paris, via 
Bordeaux and Dax, is situated on a small table-land about 
700 feet above the sea, in the department of the lower 
Pyrenees, one hundred and fifty miles from Bordeaux, and 
twenty miles from the nearest part of the Pyrenees. The 
platform on which the town stands is intersected by a deep 
ravine, through which a scanty and very dirty rivulet flows, 
" stealing and giving odours." On the north of this ravine is 
the new town, in which are many of the public buildings, and 
most of the houses inhabited by foreign visitors. 

The old town, on the opposite side of the river, as seen from 
the bridge, reminds one somewhat of Edinburgh on a small 
scale. In this quarter are the Prefecture, the Chateau Henri 
IV., and the Place Royal, where stands the beautiful statue of 
Henry of Navarre, erected by Louis Philippe. This promenade 



70 PAU. 

commands an exquisite view of the rich valley of the Gave, 
and an unbroken vista of the Pyrenees for fully sixty miles. 

The streets of Pau are dirty and badly paved, but the shops 
are well supplied with goods suited for English customers. The 
hotels, especially the Hotel Beau Sej our and the Hotel de laPoste, 
are comfortable and not expensive. Apartments may also be 
had at all prices, from one thousand to ten thousand francs for 
the season from October to May. It is essential to choose rooms 
commanding a northern aspect, and having fire-places, as there 
is a difference here generally of 10° or 12° between the north 
and south side of the same house, and the nights are always, 
and the days generally, cold enough to render a fire necessary 
in winter. In most of the houses the sewerage is very defective, 
and the effluvia in the halls and staircases, especially in wet 
weather, may be better imagined than described. 

The climate of Pau has been written up very assiduously, 
and highly extolled for its peculiar advantages during eight 
months of the year, including the entire of the winter, as 
an especially well-adapted place for invalids labouring under 
diseases of the respiratory organs. But no amount of eulogy 
affects the temperature of a locality, or improves the hygro- 
metric condition of its atmosphere. And, therefore, though 
the books that have been written on Pau have answered 
their purpose most successfully, by annually bringing crowds 
of invalid travellers to spend the winter months in a locality 
in favour of which they have read such strong and circum- 
stantial statements, still the climate remains what it was be- 
fore the books were written — essentially cold, variable, damp, 
and dreary during the winter. 

I should feel some hesitation in offering so unfavourable an 
opinion of this climate, which is almost universally regarded 
as one of the finest in the south of Europe, if I had not had 
some personal experience of its action on invalids in whom I 



PAU. 71 

was interested. Moreover, I have been favoured with very 
extensive unpublished meteorological and other observations, a 
resume of which will be found in this chapter. 

Confiding in the works on this climate I had read, I arrived 
in Pau from Algiers in the beginning of January, expecting 
to find a mild, equable, and genial climate. I was soon 
undeceived, however ; the change was literally from an atmo- 
sphere warm and bright as summer in this country, to one 
nearly as cold and damp as that of London in mid-winter. The 
evenings were foggy and the mornings misty, and during the 
month of January there were few days on which any person 
suffering from pulmonary disease could go out of doors with- 
out prejudice to health. At Algiers, during the month of 
December, the thermometer as observed by me never fell 
below 54° at any hour of the day or night; while at Pau during 
the same month, according to the observation of M. Weil, 
the mean temperature of the day was considerably under 
the lowest temperature of the twenty-four hours at Algiers, 
being 45 £°, and the thermometer fell eleven times to zero. 

Probably the best mode of studying a climate is by com- 
paring it with others, and therefore I will now contrast Pau 
with Dublin, which may be considered a specimen of a bad 
climate ; and likewise with Malaga, which I regard as a very 
good one. The mean annual temperature of Pau is 56°, or 7° 
higher than that of Dublin and 9° lower than that of Malaga. 
The mean temperature of winter is 42°, or 3° higher than 
Dublin and 13° lower than Malaga. The mean temperature 
of spring is 54°, or 7° higher than Dublin and 14° lower than 
Malaga. In summer the mean temperature of Pau is 70°, or 
11° higher than Dublin and 8° lower than Malaga. And, 
lastly, the mean temperature of autumn is 58°, which is 
8° higher than that of Dublin and 2° lower than that of 
Malaga. 



72 



PAU. 



From this we learn that in winter, when this town is 
crowded by English invalids, the temperature of Pau is only 
3° higher than that of one of the worst climates in Great 
Britain, and is 13° lower than that of Malaga. In spring, 
however, the climate is somewhat better. 

The following tables, the first of which is copied from the 
registry in the club at Pau, and the second arranged from a 
valuable register kindly given me by M. Weil of that town, 
will afford the reader some idea of the character of this 
climate. 

Table showing the comparative Meteorology of Pau and of 
Kew Observatory during an average Winter. 





October. 


November. 


December. 


Pau. 


Kew. 


Pau. 


Kew. 


Pau. 


Kew. 


Mean temperature at 9 a. m. , 
Mean of the highest temperature ) 

by day in each twenty-four hours \ 
Mean of the lowest temperature by ) 

night in each twenty-four hours ) 
Mean temperature of the months ) 

calculated from preceding obser- > 

vations, . . . . ) 
Number of days in which the ) 

thermometer fell to freezing > 

point, ) 

Number of days on which rain fell 
Amount of rain in inches and ) 

hundredths, \ 
Mean amount of cloud, 
Mean moisture of air, 


60'5 
70-5 

52 
60-4 



7 
1-28 

4-2 

•79 


55-6 
61-6 

48 
55'1 



10 

074 

7 
•85 


447 
57-3 

41-8 
49-1 

1 

14 
2-734 

53 

•82 


41 
46'6 

33'2 
39-5 

13 

20 
1-054 

6-1 

•85 


41-7 

52 
37-9 

45 

5 

8 

1-275 

4 
•83 


40 

45 

34-8 
40 

11 

11 

0-925 

6 
•83 



Pau is one of the most variable climates in the south of 
Europe. Thus, for instance, I have seen a difference of 20° 
between nine a.m. and noon. I need hardly add that such 
sudden changes of temperature must be injurious to con- 
sumptive patients. 

It must be , admitted, that if we contrast the comparative 
number of rainy days at Pau and Dublin, the advantage will 



PAU. 



73 



be on the side of the former. Thus, in Dublin, the average 
annual number of wet days is 224, while in Pau there are 
only 119 ; yet in Pau " it never rains but it pours," for the 
actual quantity of rain which falls is 42 inches, or 15 inches 
more than at Dublin, and 26 inches more than at Malaga, 
where there are only about 30 rainy days annually. 

Temperature at Pau. 



Date. 


December. 


January. 


February. 


March. 


c 


a 
o 


6 


a 


c 

o 


a 


a 


s 


a 


a 


© 


a 




;£ 


o 


p. 


03 


o 


&< 


si 


o 


p5 


ej 


o 


Pi 




Ci 


£ 


M 


Ci 


fc 


a 


OJ 


(25 


M 


C5 


fe 


TO 




o 


o 


o 





o 


o 


Q 








c 


c 





1st 


43 


52 


54 














44 


53 


55 


2d 


41 


52 


54 


41 


48 


48 


44 


46 


50 


42 


53 


57 


3d 


37 


52 


52 


41 


46 


44 


46 


50 


50 


44 


57 


59 


4th 


37 


50 


52 


33 


41 


39 


41 


44 


42 


39 


41 


44 


5th 


36 


45 


46 


41 


44 


44 


39 


41 


39 


41 


46 


50 


6th 


43 


50 


50 


41 


46 


44 


39 


41 


44 


42 


53 


59 


7th 


54 


55 


55 


41 


46 


46 


37 


41 


37 


44 


59 


64 


8th 


43 


54 


55 


39 


44 


46 


32 


35 


35 


50 


66 


71 


9th 


45 


52 


54 


46 


48 


53 


24 


24 


26 


53 


69 


71 


10th 


49 


54 


55 


50 


59 


59 


21 


28 


30 


48 


53 


46 


11th 


49 


54 


54 


42 


53 


55 


21 


28 


35 


44 


48 


48 


12th 


41 


54 


55 


41 


50 


50 


23 


35 


35 


44 


46 


46 


13th 


43 


52 


54 


46 


44 


42 


24 


37 


37 


42 


41 


41 


14th 


43 


49 


50 


41 


41 


41 


28 


48 


48 


41 


50 


51 


15th 


41 


52 


54 


39 


41 


41 


48 


50 


50 








16th 


43 


52 


49 


37 


39 


37 


37 


48 


48 








17th 


43 


46 


45 


26 


35 


37 


37 


48 


48 








18th 


43 


45 


45 


26 


30 


33 


39 


50 


48 








19th 


41 


45 


43 


26 


35 


37 


37 


41 


44 








20th 


37 


37 


40 


32 


39 


41 


41 


44 


48 








21st 


40 


41 


41 


32 


48 


48 


39 


46 


42 








22d 


34 


43 


46 


41 


46 


48 


41 


44 


46 








23d 


37 


49 


49 


42 


50 


51 


37 


39 


42 








24th 


36 


46 


49 


48 


57 


57 


42 


50 


50 








25th 


36 


46 


46 


46 


53 


50 


37 


41 


39 








26th 


36 


50 


49 


46 


51 


50 


42 


48 


50 








27th 


36 


43 


43 


35 


50 


50 


44 


50 


48 








28th 


30 


49 


43 


41 


55 


57 


35 


37 


39 








29th 


36 


43 


43 


41 


55 


57 














30th 


34 


50 


50 


42 


46 


48 














31st 


34 


50 


50 


44 


46 


48 















The hygrometric aspect of this climate seems to me to be 
completely misunderstood: In his well-known work on Pau, 
Sir Alexander Taylor makes the assertion, which has so often 
been copied by other writers as to be now regarded as an 



74 pau. 

established fact, that " there is a peculiar absence of free 
communicable humidity in the atmosphere at Pau."* 

If we test this statement by comparing the climate of Pau 
with some place where there is no " peculiar absence of free 
communicable humidity in the atmosphere," such as Kew, 
near London, for instance, we shall find little proof of this 
boasted superiority ; thus during the month of November, in 
the first winter that I visited Pau, the mean moisture of the 
air denoted by the hygrometer was '82 at Pau, compared with 
'85 at Kew ; and in December the mean moisture of the air 
at Pau was '83, which was exactly the same as at Kew. 

During my two visits to Pau, in October and January, 
there was a continual combination of cold and fogs in the 
mornings and evenings. In January the thermometer wa^ 
frequently below freezing point during the night, and there 
were few days on which some rain did not fall. 

It is certainly true, however, that there is here a peculiar 
stillness of the atmosphere, and generally a great freedom 
from harsh and violent winds, which is especially obvious in 
spring. This, though in some respects an advantage, is not 
an unqualified one, the stagnation of the air giving rise to a 
weak and languid circulation, generally accompanied by a 
corresponding state of mental and physical relaxation and 
inertia. And it has been remarked that the Bearnaise differ 
from the French in general, in being of less excitable disposi- 
tion and more placid temperament. Prom this sedative 
action it has been argued that the climate should prove 
useful in chronic diseases attended by much vascular 
excitement, and indeed I was told by some of the English 
residents in Pau, that they had noticed a considerable reduc- 
tion in the frequency of the pulse on their first arrival. I 

* ' ' The Curative Influence of the Climate of Pau and the Mineral "Waters 
of the Pyrenees on Disease," by Alexander Taylor, M.D., p. 42. 



PAU AND ARCACHON. 75 

may remark that this effect was not produced on those whom 
I had an opportunity of observing, but, on the contrary, the 
opposite symptoms followed the arrival in Pau of two 
persons under my immediate notice. In both cases the 
acceleration of the pulse was caused by the cold, damp, and 
ungenial climate of Pau aggravating the ailments of these 
individuals. 

Eheumatism is a common complaint here, and a strong 
presumption is thus afforded that the climate is unsuited for 
persons suffering from that affection. Sir Alexander Taylor 
admits that bronchitis is not unfrequent in Pau during the 
winter and spring, but he considers that it is of a less severe 
character than in this country. 

From the foregoing account of this climate and its effects I 
draw the conclusion, that the variable temperature of Pau 
renders that town unsuited for the winter residence of consump- 
tive patients, in whom the disease has progressed to its second 
or third stage. It would be a bad abode in most cases of chronic 
bronchitis, and, according to the testimony of an eminent resi- 
dent physician, peculiarly unsuitable in cases of fatty degenera- 
tion and certain other chronic diseases of the heart. 

On the other hand, this climate may occasionally act 
beneficially in some cases of incipient phthisis, when a pure 
mountain air is required ; and perhaps also in some instances 
of that disease in its first stage. But even in such cases I 
think that a more bracing and more equable climate is 
generally required. 

With regard to asthmatic patients I must, however, modify 
what I said in my first work on this subject, as further experi- 
ence has convinced me that in many cases of spasmodic asthma, 
Pau agrees better than any other climate. 

Arcachon has of late years come into vogue as a spring 
and winter residence for pulmonary invalids, and there- 



v 



76 ARCACHON. 

fore on my return from my last visit to Pau I made a short 
stay in this village. Arcachon lies an hour's journey by rail- 
way to the south-west of Bordeaux, being situated in a pine 
forest, and on the shore of an immense lagoon, which opens 
by a narrow channel into the Bay of Biscay. 

As Arcachon is chiefly known as a health resort for British 
invalids, in consequence of Sir Dominic Corrgian's recommenda- 
tion of it in a presidential address delivered some years ago, 
and as this is now out of print, and contains the best account 
yet published of Arcachon, I shall here summarise that 
eminent physician's graphic description of this health resort. 
According to Sir Dominic Corrigan, Arcachon owes its exist- 
ence to the commander of a merchant vessel, who, in 1826, 
established an hotel in this place. "Adopting the style to 
which he had been accustomed in India, he built his first 
establishment of wood after the model of a 'bungalow' — a 
one-storied house with a verandah running round it, into which 
all the rooms open. The model has been universally adopted, 
and the watering-place of Arcachon now consists of hundreds 
of such isolated houses, with magnolias, oleanders, and orange 
trees around them, giving the whole place the picturesque 
appearance of clusters of Indian bungalows in an American 
pine clearing. In 1844 the opening of a railway gave a fresh 
impetus to its progress, and Arcachon is now, apparently and 
deservedly, one of the most favourite spring residences on the 
south-west coast of France for invalids labouring under some 
forms of pulmonary affections. I have obtained some short 
notes of the temperature from Dr Hameau, the resident physi- 
cian, and he assures me that during the last winter — which had 
been unusually severe — the thermometer (Fahrenheit) only 
fell four times in December, and three times in February to 
freezing point, and this was on the beach. In January and 
February, it appears from his tables that the temperature in 



AKCACHON AND BIAEEITZ. 77 

the forest is usually abou t44° to 50° of Fahrenheit. . . . 
Arcachon is free from the vicinity of any high mountain 
ranges that might pour down upon it cold, dry, and harsh air, 
while it is sheltered by sandhills of moderate elevation ; and it 
presents with this the additional advantage of sea air without 
the violence of sea gales. There is another peculiarity to which 
much of the salubrity of the air of Arcachon, as a residence, 
is attributed — for it has a high local repute in pulmonary 
affections — and that is the great belt of pine forest which 
extends for many miles around it. The whole air is perceptibly 
impregnated with the balsamic odour of turpentine, and we 
know that the balsams and turpentines in vapour are remedial 
agents of much power in bronchial affections/' * 

On the same coast, and also within the limits of the 
same vast sandy plain in which Arcachon is situated, is 
another locality which has still more recently been recom- 
mended as a winter resort, namely — Biarritz. Since I first 
visited the district of the Landes the population of Biarritz 
has more than trebled ; and, chiefly owing to the preference 
given to it by the ex-Imperial family of France, this town has 
been metamorphosed from a mere fishing village into one of 
the most fashionable sea-side watering-places in Europe. It 
is unnecessary to describe a locality so well known and so 
accessible, being within five hours' journey by train from 
Bordeaux, and only six miles from Bayonne. Nor would I have 
made any reference to this town were it not that, not satisfied 
with the repute which Biarritz has justly acquired as the first 
amongst the sea-side resorts of France, an attempt has been 
made by some writers to take advantage of the prevailing 
opinion in favour of tonic winter climates for pulmonary inva- 
lids, and to write Biarritz, as other places have been, and with 

* Sir D. Corrigan, " Introductory Address Medical Society College of 
Physicians," p. 12. 



78 BIARRITZ. 

even less justice written, into value as a fitting winter resi- 
dence for consumptive patients. But notwithstanding its 
unquestionable advantages of facility of access, beauty of 
situation, and excellence of accommodation and living, still 
the position of this town, which is fully exposed to violent 
Atlantic storms and consequent frequent and sudden changes 
of temperature during the winter and spring seasons, the pre- 
valence of humid south-westerly winds, and the large number 
of wet days, amounting on an average to one hundred and 
twenty annually, obviously render Biarritz unsuitable as a 
winter abode for pulmonary invalids. 



MONTPELLIER. 79 



CHAPTER XL 

MONTPELLIER. 

Towards the close of the last century Montpellier was the 
best known and most frequented health resort on the Con- 
tinent. But its reputation in this way has long been eclipsed 
by other localities now in fashion. 

This place is within sixteen hours' journey of Paris by the 
Marseilles line, a branch of which, from Tarascon, passes the 
town. 

Montpellier is situated on a hill in the centre of an extensive 
sandy plain, evidently once the bed of the sea, from which it 
is now six miles distant. The streets are narrow and very steep, 
the principal leading up to the " Place du Peyrou," from which 
the tourist may enjoy one of the most beautiful views in the 
south of Europe. 

The town contains little to attract the notice of the visitor, 
with the exception of the Musee Pabre, the Jardin des Plants, 
and the ancient building occupied by the Eaculty of Medicine, 
amongst whose students I was once enrolled, and might there- 
fore be suspected of partiality if I were to say more than that, 
from its foundation in the tenth century down to the present 
day, this school has maintained a reputation unsurpassed by 
any of the larger and more modern centres of medical educa- 
tion. The classes are not very largely attended, however, and 



80 MONTPELLIER. 

the nnmber of those who are here invested in the robe of 
Kabelais is now comparatively small. 

In the vicinity of Montpellier the line of coast from the 
embouchure of the Ehone as far as Cette is bordered by lakes 
and marshes. The ground on which the town stands is of a 
loose gravelly formation, and in the neighbourhood a consider- 
able amount of mercury is found in small cylindrical veins in 
the soil, and the peasants attribute the mortality amongst 
cattle, in certain localities, to mercurial exhalations from the 
earth. 

The winter climate of Montpellier, although warm, is ex- 
tremely variable. The mean annual temperature is 56°, 
which, compared with Malaga and with London, is 9° lower 
than the former and 6° higher than the latter city. As a 
comparison of this kind seems to me the best way of under- 
standing the value of meteorological observations, I shall also 
apply it to the seasons. Thus the mean temperature of winter 
at Montpellier is 41°, or 14° lower than Malaga and 2° higher 
than London ; the mean temperature of spring is 55°, or 13° 
lower than Malaga and 7° higher than London. The hottest 
month is July, and the coldest is January, and the mean daily 
range of temperature is 12°. 

Within the last sixty years the climate of Montpellier has 
become considerably drier than it was. In the latter part of 
the 18th century the annual rainfall was 778 millimetres, and 
in the first half of the present century it only amounted to 662 
millimetres, being a decrease of 116 millimetres a year within 
this period. The annual number of rainy days has fallen from 
179 to 58 within the same time. The maximum number of 
wet days occurs in October, and the minimum in February. 

The prevailing winds in Montpellier are, first, the north- 
west or " Magistraou." This blows for about 78 days 
annually, and during its prevalence the town is healthier than 



MONTPELLIEft. 81 

at any other time. The north wind or " Tramontana " is felt 
about 74 days in the year, and in winter, when it is termed the 
" Bise," is cold and harsh, but in summer is hot and parched. 
The east is a rainy wind, occurring on about 60 days annually, 
and crossing the marshes of Aiguesmorts, arrives at Mont- 
pellier pregnant with malaria. Southerly winds generally 
prevail in summer, and are cool and humid. 

Although snow is rarely seen here, hard frosts are common 
during the winter, and violent hailstorms recur periodically 
every few years. Fogs are seldom observed, but the dew-fall 
is very considerable, so as to render it essential for invalids to 
remain within doors after sunset. 

The atmospheric constitution of Montpellier is characterised 
by dryness and moderate warmth, accompanied by a tendency 
to great and sudden alterations of temperature, and the 
occasional prevalence of strong winds. It is manifest that 
a combination such as this cannot agree in cases of con- 
sumption. 

In his excellent work, Dr Eodriguez has shown that 
" pulmonary consumption has increased in Montpellier since 
the close of the last century ; it is often hereditary, and its 
exciting cause is generally ascribed to catarrh.'" " It is not 
uncommon," he tells us, "to meet with acute inflammatory 
phthisis or galloping consumption, especially in young- 
girls."* Montpellier cannot therefore be recommended as a 
desirable winter resort for those suffering from phthisis, 
although even in that disease I am inclined to believe that 
this climate is as good as that of some other places recently 
brought into vogue as health resorts. 

The cases which I think most likely to be benefited by the 
climate of Montpellier are cases of humoral asthma, and chronic 
laryngeal and bronchitic affections, attended with profuse 

* " Clinique Medical de Montpellier," par le Dr Rodriguez, p. 382. 

F 



82 MONTPELLIEE. 

expectoration, and not accompanied with much irritation. 
These may in some cases improve rapidly under the influ- 
ence of this climate, provided great care be taken to avoid 
exposure to the bise and mar in winds. 

The climate of Montpellier may be also tried in some 
forms of dyspepsia, climacteric disease, and hypochondriasis, 
attended with a slow circulation, and where the feelings are 
not morbidly acute. 



HYEKES AND CANNES. 83 



CHAPTER XII. 

HYEEES AND CANNES. 

Fkom Montpellier to Hyeres, there is a wide transition of 
climate, although both towns are within the ancient limits of 
" Fair Provence." For brilliant as is generally the sun, cloud- 
less the sky, and serene the atmosphere of this entire region, 
yet the extreme inconstancy of the temperature renders the 
greater part of it unsuitable for the residence of pulmonary 
invalids. So changeable indeed is the climate, that Louis 
XIV., who certainly knew something about ladies, if nothing 
about climates, very happily compared it to " une coquette 
jparfume'e dont il fallait se m^fierT 

A long narrow strip of land extends along the Mediter- 
ranean from Toulon to Mce, and thence is continuous with 
the Eiviera del Ponente. This is included between the 
secondary chain of the Maritime Alps and the sea, and being 
protected by these mountains from all cold winds, and espe- 
cially from the " Mistral," is thus blessed with a climate very 
different from that of Provence in general. Enjoying the 
advantages of this situation in a more than ordinary degree is 
the locality now to be described. 

The town of Hyeres is situated in the department of the 
Var, near the western boundary of the Gulf of Lyons, about 
two miles from the shore, and is connected with Paris by the 
railway to Toulon, from which it is nearly twelve miles distant 
on the road to St Tropez. The town is small, having a popu- 



84 HYEKES AND CANNES. 

lation of some 10,000 inhabitants. The older portion is built 
on the side of a precipitous hill. 

Foreign invalids for the most part inhabit the modern part 
of the town about the Place de Palniiers, Place Koyal, and 
Place de la Kade, where the best lodging-houses and hotels are 
situated. There is a " Cercle " or club, and a lending library, 
both well supplied with English books and papers. An 
English Protestant church has also been erected in the Place 
de Palmiers. English physicians reside in the neighbourhood, 
and amongst these I may be pardoned for mentioning the 
name of my friend Dr Griffiths, who has been for many years 
in extensive practice in Hyeres, and to whom I am indebted 
for valuable information respecting the climate. Living is 
cheap and good; and all the necessaries, and most of the 
commodities, a sick man requires, are to be easily procured 
here. 

The climate of Hyeres is warmer and more equable in 
winter than that of Nice ; it is also stated to be drier, but at 
the same time less exciting than that town. The average 
number of rainy days in Hyeres being only 40, while in the 
latter locality it amounts to 60 days yearly ; and the number 
of inches of rain annually is about 27, which is a little more 
than at Nice. 

During the winter the prevalent winds are north, north-east, 
south, and south-east ; and in spring they are thus arranged 
by M. Carriere, in the order of their frequency — east, south- 
east, and north-east. 

Dr Griffiths, in a note appended to some valuable meteoro- 
logical tables with which he favoured me, says,- — " The rain, it 
will be observed, mostly falls at night, so that there is rarely a 
day when the invalid may not go out for some little time. 
The 'Mistral', (N.W. wind), as described in 'Murray,' is 
almost never seen in Heyres; and when it does prevail, is 



HYEKES AND CANNES. 85 

not to be compared, for dust and discomfort, to the ' Terral ' 
in Malaga." 

Snow is seldom seen here, and according to Dr Gigot-Suard 
it only snows once every three years, and then, but for a very 
short time* 

Generally the climate may be said to be fitted for children 
or young persons of a lymphatic temperament, or of a 
scrofulous diathesis, either predisposed to consumption, or 
suffering from the first stage of that disease. 

Bearing in mind that the atmosphere though drier, is at 
the same time less exciting than that of Nice, a residence 
in Hyeres would be likely to prove useful in cases of 
chronic mucous discharges, chronic bronchitis, neuralgia, atonic 
dyspepsia, and some other diseases, in which the climate of 
Nice would be unduly tonic, or stimulating. 

Cannes is situated at the extremity of the bay of the same 
name, on the road from Toulon to Nice, and is about twenty- 
one miles to the south-west of the latter town. The plain on 
which it stands is enclosed on the north and west by the 
Maritime Alps and the Estrelles, but on the east this mountain 
barrier is not complete; while towards the south the plain 
is open to the Mediterranean. 

Opposite to the town are "les isles de Lerins," of which the 
larger, St Marguerite, is famous for having been the scene of 
the long incarceration of the mysterious "Man in the Iron 
Mask," in the seventeenth century. 

In the valley of Cannes, vegetation is peculiarly luxuriant. 
The natural beauty of the scenery is much increased by the 
soil being mainly devoted to the culture of odoriferous plants 
and flowers, from which perfumes are [here very extensively 
manufactured. 

The town, though a thriving place, and possessing a 

* Gigot-Suard, "Des Climates, " p. 154. 



86 HYERES AND CANNES. 

population close on 5000 inhabitants, contains in itself but 
little to interest the casual visitor. The principal street, 
containing a few hotels and lodging-houses, is built along 
the high road to Italy, and is separated from the beach by a 
public promenade. On the hill above this is the ancient 
Church of "Notre Dame d'Esperance," a shrine renowned 
among the mariners of Provence. 

On the same side are the environs, chiefly inhabited by 
foreign invalids, and also the Scottish church, above which is 
the magnificent castle of the Dake de Valambrosa. 

The climate of Cannes is peculiarly equable as well as 
moderately warm in winter. The mean annual temperature 
is about 60°; and Dr Seve, of this town, gives as the result of 
the observations of fourteen years, the following table of 
the mean temperature of the seasons : — 

Winter, . . 50° I Summer, . . 71° 
Spring, . . 62° I Autumn, . . 55° 

The prevalent wind at Cannes is the sea-breeze from the east 
and south-east. North and west winds are, to a certain 
extent, excluded by the maritime Alps on the one side, and 
the chain of the Estrelles on the other. Violent winds, and 
the " Mistral," are said to be less felt here than at Hyeres. 

The annual number of rainy days at Cannes is fifty- two, or 
twelve more than at Hyeres, and eight less than at Mce. 
Whilst with regard to the actual amount of rain which falls, 
the proportion is reversed, as the annual rainfall at Cannes 
amounts to 25 inches, being 2 inches less than that of Hyeres, 
and the same as Mce. 

The exciting character of the climate of Cannes is, by native 
authors, attributed to a highly electrical condition of the 
atmosphere. 

I have very little to add with respect to the sanative appli- 
cation of this climate ; but its electrical condition, its equable 



HYERES AND CANNES. 87 

warmth and dryness, and the stimulating properties of the 
atmosphere, all would indicate its fitness for scrofulous and 
lymphatic temperaments. It might probably be also resorted 
to in some few cases of consumption occurring in persons of 
these temperaments, and marked by symptoms of langour and 
debility ; in similar cases of chronic bronchitis, and in certain 
low nervous affections. 



88 NICE. 



CHAPTEE XIII. 



NICE. 



As a sanatorium for foreign invalids, Nice possesses some 
natural advantages, as well as many artificial ones. Among 
these may be included the many facilities for reaching it by 
land and sea, the beauty of its situation, and the superiority of 
the accommodation it affords; all of which are important 
accessories to the purity of its atmosphere, and the serenity of 
its sky. So far back as the fourth century we find these latter 
celebrated by Ausonius : — - 

" Nicsea est Natale solum, dementia coeli 
Mitis, ubi est riguse larga indulgentia terrae, 
Ver longum, brumseque breves, juga frondea subsunt." 

Situated on the verge of a valley formed on three sides by 
the Maritime Alps, and opening to the Mediterranean on 
the south, Nice lies 170 miles from Marseilles, and 213 miles 
from Genoa. The mountains, which in great measure shelter 
the valley of the Paillon from cold and harsh winds, also 
serve to concentrate and radiate the solar rays on the town, 
and in some degree account for the peculiar mildness of the 
climate during the winter. 

The town is built around the base "of a lofty promontory 
surmounted by the ruins of a fortress. To the east of this 
rock is the port, and around its base, on that side, are congre- 
gated the crowded, narrow streets of the old town. The river 



NICE. 89 

Paillon, which flows through the town, is bordered on its 
eastern quay by a handsome boulevard which connects the 
port with the new town. Opposite the Pont Neuf is the 
suburb of the Croix de Marbre, which is principally occupied 
by foreign invalids, of whom the majority are English or 
Americans. The hotels, of which the visitor has his choice 
of at least a score, are chiefly situated on the western side of 
the river, or in the Promenade des Anglais, and are generally 
better than in most French provincial towns, and also some- 
what more expensive. 

Next to the climate of a place, the agrtmens or amusements 
it possesses are justly the most important consideration for the 
invalid visitor, who having abandoned his accustomed employ- 
ment, and seldom bringing books with him, depends on them for 
the means of occupying his mind, and spending his time. These 
are better provided for in Nice than in any other southern 
city I am acquainted with, except Naples. Moreover, even in 
the depth of winter there are very few days in Nice on which 
some hours of sunshine and warmth do not occur, and, con- 
joined to the advantages of good roads, easy conveyances for 
reaching the many places of interest about, and the exquisite 
beauty of the scenery in the neighbourhood, afford the most 
delicate valetudinarian an opportunity and temptation for 
going out, and thus availing himself of the great accessories 
to health — pure air and moderate exercise. 

The climate of Nice is essentially of a dry, warm, tonic, and 
exciting nature. According to the Chevalier Macario, whose 
calculations are founded on the observations of preceding 
writers for the last fifty years, the mean annual temperature 
of Nice is 60°; that of winter 48°, spring 55°, summer 71°, 
and autumn 62°. The temperature is very steady, the varia- 
tions from month to month not exceeding from 2° to 3°. 

There are, on an average, 229 bright, cloudless days annually 



90 NICE. 

at Nice, 66 cloudy days, and about 60 rainy days, the average 
rainfall amounting to 26 inches, of which one-half falls in 
autumn, and one-fourth from October to February. 

In winter the prevailing winds in the order of their frequency 
are north, east, and south ; and in spring east and south winds. 
The northerly winds from the snow-covered Alps are attended 
by cold, dry weather, and principally prevail in spring, at 
which season, conjointly with the east or west winds, they 
occasionally blow with great violence along the valley of the 
Paillon, and those parts of the town that border on the river. 

The " Mistral " is shut out to some extent by the mountains 
between Freju sand Cannes ; still, a cold, dry, irritating wind 
from the north-west occasionally occurs, but only lasts for a 
few hours. The east winds in spring are the great drawback 
to Nice, and during their prevalence no invalid should think 
of leaving the house. 

We have now to consider the practical application of the 
foregoing observations. And on this subject we find the most 
contradictory opinions expressed by various writers on the 
climate. The majority of invalids who are sent to Nice suffer 
from pulmonic disease of some kind, " Voulez-vous savoir" 
tersely asks Monsieur Champouillon, " ce que deviennent les 
tuberculeux d Nice? Allez au cimetiere." Dr Fodere of 
Strasburg, who lived in Nice for several years, says — " Here 
the disease is not chronic as in Switzerland, or in Alsace ; 
but I have very often seen it terminate within forty days, 
and a physician of the. country I have just named would be 
astonished with the rapidity with which haemoptysis sets in, 
the tubercles suppurate, and the lungs are destroyed."* 

Dr Farr says— " Independently of the ' Mistral,' the easterly 
wind sets in with the first moon in March. I besought those 

* " Voyage aux Alpes Maritimes, ou Histoire Naturelle, Du Pays de Nice." 
p. 184. 



NICE. 91 

whom I attended, and many whom I did not, to quit Nice 
before the birth of this fatal moon ; but they heeded not my 
counsel, and thought that I had over-rated the danger. They 
remained, and the day after this easterly wind began ; of the 
thirty, I only met one afterwards, and him I had often 
previously pronounced to have no disease of the lungs." * 

A resident physician, Dr Wahu, states that — " It would be 
the greatest mistake to assert that Nice, on account of its 
climate and hygienic conditions, is the locality which agrees 
with phthisical patients."t 

The late Sir James Clark says — " Indeed, sending patients 
labouring under confirmed phthisis to Mce will, in a great 
majority of cases, prove more frequently injurious than 
beneficial.''^ 

To the preceding citations against the climate of Nice I had 
intended to add others equally strong in its favour, from the 
works of resident physicians, who either entirely deny, or 
explain away, the foregoing conclusions. 

Amongst these I had taken extracts from Eichelmi,§ 
Eoubaudi,|| Chevalier Macario,1F Dr Edwin Lee,** and some 
others. But it has been deemed advisable to leave out these 
quotations, since they only serve to illustrate the difficulty and 
uncertainty of the study of climate. 

I have already characterised the climate of Nice as being 
moderately warm, dry, and somewhat exciting, therefore it may 
be expected to agree best with those forms of disease in which 
debility and langour, attended by profuse expectoration, or some 
other exhausting discharge, are prominent symptoms. A 

* Dr W. Farr, " On the Climate of Nice," p. 16. 

t Le Dr A. Wahu, " Conseiller Medical de l'Etranger a Nice," p. 17. 

Z " The Influence of Climate," &c, p. 123. 

§ " Essai sur les Agrements et sur la Salubrite du Climat de Nice." 

|| "Nice et ses Environs." 

IF " De l'lnfluence Medicatrice du Climat de Nice." 

** " Nice and its Climate." 



92 NICE. 

residence in Nice often proves eminently serviceable to children 
of a weak and relaxed constitution, predisposed to any of the 
forms of scrofula, and therefore to consumption. It is also 
resorted to, though with less marked benefit, in cases of con- 
sumption, either in its premonitory state, or at any rate before 
it has passed into the second stage, occurring in a torpid or 
leuco-phlegmatic habit of body, and not accompanied by 
symptoms of active inflammation. 

Patients suffering from chronic bronchitis and senile winter 
cough, often derive singular benefit from the climate of Nice, 
the effect of which seems to consist in a diminution of the 
excessive mucous discharge, that is often the chief cause of the 
patient's weakness. And in cases of humoral asthma I have 
hesitated between recommending Nice or Malaga. 

Cases of chronic rheumatism occurring in persons of scrofulous 
habit occasionally derive advantage from a residence in this 
town ; but it must be recollected that the climate is not exempt 
from great and sudden atmospheric vicissitudes, and that 
rheumatic patients must be very cautious to avoid exposure to 
these. Change of climate undoubtedly exercises a wonderful 
control over the manifestations of gout, and in most cases a dry, 
warm climate, such as this, is calculated to be useful. 

The hills of Cimies, and Carabacel, to F the north-east of the 
town, contain some of the best residences in the vicinity of 
Nice, and the climate would render them all that could be 
desired, were it not that the deficiency of good drinking water 
is a very considerable drawback. To the north are Le Eay 
and St Barthelemy, which have a similar aspect to Cimies, 
and are suited for the same class of patients. 



MENTONE AND THE RIVIERE. 93 



CHAPTEE XIV. 

MENTONE AND THE RIVIERA, 

Within an hour's journey by railway from Nice is a locality 
which has been very assiduously and ably written into vogue 
as a winter resort for pulmonary invalids, and has rapidly risen 
from an obscure village to the position of one of the best known 
and most fashionable health resorts of southern Europe. The 
reputation which Mentone has thus acquired is chiefly due to 
Dr J. H. Bennet who, having here regained his own health, 
impaired by arduous professional labour in London, concluded 
that the climate which agreed so well with himself must needs 
suit other invalids, and published a work which, from its first 
edition to the last expanded treatise he has recently brought 
out on the same subject, has throughout one predominant 
theme, namely, the reiteration of the asserted superiority 
of the Mentonian climate. 

Mentone, or Menton as the Erench call it, is an ancient 
Italian-looking town, charmingly situated on the sea-shore, 
about twenty miles east of Nice, with which it is connected 
by railway. The town itself consists of a long, straggling 
street running parallel to the shore, and of a few lanes which 
ascend the hill, whilst outside the town are scattered on all 
sides a considerable number of large hotels and villa residences 
which are chiefly occupied by English, American, and other 
foreign invalid visitors. 

To meet the wants of so large a transitory population 



94 



MENTONE AND THE KIVIEKA. 



English shops have been opened, English doctors have estal> 
lished themselves, and a club with assembly rooms, concert 
hall, &c, set up. The principal hotels are tolerably good, and 
the charges are about the same as at Nice. 

Before Dr Bennet became the panegyrist of the Mentonian 
climate, this place had been favourably noticed as a health 
resort in M. Carriere's well-known work on the Italian 
climates, and long previously its supposed advantages had 
been pointed out by Dr Eodere of Strasburg. The advantages 
attributed by those and other writers to the climate of 
Mentone are, a warm and equable temperature, exemption 
from harsh and cold winds, and particularly the " Mistral," a 
somewhat sedative atmosphere, facility of approach, and 
convenient residences suitable for invalids. 

According to M. Brea, the mean annual temperature of 
Mentone is 60°; the maximum observed was 80° in August, 
and the minimum 32° in January. 

Mean Temperature, of the Months. 



January, . 


o 

. 48 


May, 


. 63 


September, 


o 

. 69 


February, 


. 48 


June, 


. 70 


October, . 


. 64 


March, 


. 52 


July, 


. 75 


November, 


. 54 


April, 


. 57 


August, 


. 75 


December, 


. 49 



Resume of the state of the Weather during 3645 days (M. Br 6a). 

Fine, 2140 

Partly clear, partly cloudy, . . 457 

Cloudy, 248 

Rainy, 800 



Total, . 



3645* 



The author of a recent English work on Mentone, tells us, 
that the " Mistral " wind is unknown in that favoured climate, 



* "Tableaux Synoptiques des observations meteorologiques faites a Menton 
(Alpes Maritimes), par M. de Brea, Sous-Intendant Militaire en retraite." 



MENTONE AND THE RIVIERE. 95 

but at the time of my visit to Mentone in March, I was 
informed that the " Mistral " had been raging for some days 
previously, and my informant was much amused at my 
incredulity on the subject. 

Nor, considering the position of this village, is it possible 
that it can be exempt from strong and cold winds ; situated in 
front of Corsica, whose mountains are covered with snow 
during the winter, it cannot escape the ill effects of that 
proximity. 

Dr Bennet, in the first edition of his work on Mentone, 
says : — " To live at Mentone is really like living on ship 
board, for, as already stated, the greater part of the inhabited 
tract is a mere ledge at the foot of the mountains. There are 
very few houses inland."* In this passage Dr Bennet has, how- 
ever unintentionally, made use of a strong argument against 
Mentone as a residence for invalids ; for, as Sir Dominic 
Corrigan well observed in the monograph I have already 
quoted : — " No locality that is small in extent, no matter how 
favourable it may seem, is desirable; for if a turn round a hill, 
or a different aspect at a short distance, give a considerable 
change of temperature, the locality is unsuitable, both on this 
account and because the resident is there confined to too small 
a space, and body and mind suffer." 

Dr Edwin Lee in his " Notice of Menton," says — " Inflam- 
mation of the lungs, pleura, and air-passages, not unfrequently 
terminating after repeated attacks, or from debility of con- 
stitution in phthisis, is of frequent occurrence amongst the 
inhabitants, especially of the lower class, who, being badly 
fed and clothed, are sooner affected by atmospherical changes. 
Consumption, likewise, sometimes occurs, irrespective of any 
such acute attacks from anti-hygienic causes analagous to 
those I have specified in the account of Nice. The enervating 

* " Mentone and the Riviera," by J. H. Bennet, M.D., p. 61. 



96 MENTONE AND THE RIVIERA. 

influence of the climate of Menton on those destined to pass 
the whole year there, produces, however, some diseases which 
are comparatively infrequent at Mce." * 

For my own part, I need hardly add that I do not share 
the opinion of those who consider Mentone the Utopia for 
invalids generally, and the climate par excellence for pul- 
monary sufferers in particular. 

Less than an hour's journey by the railway beyond 
Mentone, and just within the Italian frontier, is the rival 
health resort of San Eemo, which, being some fifteen miles 
further from the gambling tables of Monaco, which are the 
real though unacknowledged centre of attraction for some 
tourists to the Eiviera del Ponente, is as yet less crowded by 
foreign valetudinarians. However, it already attracts a con- 
siderable number of winter residents; and having excellent 
hotel and lodging-house accommodation, and enjoying a 
climate very similar in all respects to that of Mentone, may 
be resorted to, or should be avoided by, the same classes of 
travellers for health. In fact the whole Eiviera from Nice to 
Spezia is studded over with small towns, such as Bordighera, 
Savona, Voltri, Kervi, and many others, which, having the 
same advantages of picturesque position and mildness of 
climate as Mentone, require only improved accommodation 
and well written and roseate-coloured medico-descriptive 
eulogy 'from some resident physician, to attract as many of 
the wealthy valetudinarian population of these islands, who 
are always seeking a new health resort, in which to escape 
the leaden sky and ungenial atmosphere of our winter climate. 

* "A Notice of Menton, supplementary to Nice and its Climate," by Edwin 
Lee, M.D., p. 21. 



PISA AND ROME. 97 



CHAPTEE XV. 

PISA AND ROME. 

The prevailing opinion in favour of dry or tonic climates as 
health resorts for pulmonary invalids, well founded as it is in 
the majority of cases of phthisis, has led to the comparative 
abandonment of sanatoriums such as Pisa, which, though not 
belonging to that category, are valuable in other chronic 
diseases. 

It would be superfluous in a work on climatology to enter 
into any general description of a city so familiarly known as 
this. But it will be necessary, however, to indicate briefly 
the topographical peculiarities which influence its climate. 

Pisa, then, is situated near the maritime extremity of the 
rich alluvial valley of the Arno, thirteen miles north of 
Leghorn and forty-five miles west of Florence, with both of 
which it is connected by railway. 

The surrounding country spreads out towards the north- 
west into an extensive plain extending to the sea, near which 
the soil becomes swampy, and forms the well-known unhealthy 
fens of the Maremma Pisana, and Maremma Yolterrana; 
whilst on the opposite side of the town the chains of the 
Apennines extend. 

The city is encompassed by lofty walls nearly six miles in 
circumference, which contain within them a population of 
about 22,000 inhabitants. Some writers attribute the peculiar 

G 



98 PISA AND KOM& 

stillness of the atmosphere of Pisa to these walls, which they 
suppose act as barriers against the force of the winds. 

Pisa is divided into two very different climates by the 
Arno, which is here much wider, and if possible still more 
turbid, than at Florence. In its course through the town the 
river describes a curve, the convexity of which is directed to 
the north, and the LuDgo l'Arno to the south. This disposition 
serves to concentrate the solar rays on the former side, to the 
disadvantage of the other, and therefore on the Lungo l'Arno 
are situated the principal hotels and houses inhabited by 
foreigners, and no pulmonary invalid should think of resid- 
ing on the opposite side, where the houses are damp and 
perceptibly colder. 

To the visitor newly arrived from Paris or Naples, where 
pleasure and gaiety seem to be the chief business of life, Pisa 
presents a dreary and desolate aspect, and the traveller, who, 
recollecting the story of her long enduring greatness and rapid 
decadence, now visits her, may here learn a wholesome 
lesson on the instability of national prosperity. 

The climate of Pisa is essentially humid and warm, ap- 
proaching in these respects closer to that of Madeira than 
any other part of Europe. The humidity of the atmosphere, 
characteristic of Pisa, is a necessary consequence of the position 
of the town, and of the direction of the prevailing winds, 
which all pass over large surfaces more or less completely 
covered by water. 

The mean annual temperature of Pisa is 59°; and that 
of the seasons is — winter 44°; spring 57°; summer 73°; and 
autumn 62°. 

The prevailing winds are those from the south and south 
west, as the town is protected from the north-west to the 
south-east by the high mountains in that direction. The 
south wind is warm and moist in winter, and is favourable to 



PISA AND ROME. 99 

the class of invalids for whom this climate is adapted. But in 
summer it is dreaded as the hot " Scirocco," and brings with it 
the seeds of disease, from its passage over the stagnant 
Maremma. 

Pisa possesses an atmosphere eminently sedative, and anti- 
phlogistic. Irritation of the pulmonary mucous membrane, 
accompanied by a hard, dry cough, is assuaged, expectoration 
is increased, and the pulse becomes slower and softer. 

Such effects point out the power of the climate in allaying 
dry chronic bronchitis, especially in the aged, and at the same 
time warn us against sending consumptive patients generally, 
and more especially in the second stage, to this place, where 
the relaxing influence of the warm, moist atmosphere, would 
soon manifest itself in the augmented expectoration, diminished 
strength, and accompanying night perspirations, or diarrhoea, 
which would in all probability hasten the fate of the sufferer. 

In many cases of consumption it has been observed, that 
even a short residence in the warm, humid, and relaxing atmo- 
sphere of Pisa has been followed by severe haemoptysis. 

For children also the Pisan climate is generally too relaxing, 
and the body does not here acquire that healthy tone produced 
by a more bracing atmosphere. 

Eome belongs to the same class of climates as Pisa and 
Madeira, being humid and warm in winter and spring, but less 
equable than either of these health resorts. The late Sir 
James Clark, however, considered that in range of temperature 
Eome has the advantage of Pisa ; and from his own experience 
arrived at the conclusion that " the climate of Eome in regard 
to its physical qualities is altogether the best of any in 
Italy/'* More recent writers, however, do not agree in this 
opinion. 

The mean annual temperature of Eome is 60°, or 8° lower 
* Sir James Clark "On the Influence of Climate," &c. p. 143. 



100 PISA AND ROME. 

than Madeira, and the same as that of Pisa. The mean tem- 
perature of winter is 49°, or 11° lower than Madeira and 2° 
higher than Pisa ; the mean temperature of spring is 58°, or 4° 
lower than Madeira and 1° higher than Pisa; in summer the 
mean temperature of Eome is 74°, or 3° higher than Madeira 
and 3° lower than Pisa ; and in autumn the mean tempera- 
ture of Eome is 62°, or 4° lower than Madeira and 1° higher 
than Pisa. 

The annual number of rainy days in Eome is 117. During 
the winter and spring southerly winds are prevalent; but 
before and after sun-set a cold, northerly breeze is commonly 
observed at these seasons The atmosphere of Eome is gene- 
rally peculiarly still during the winter. But this stillness is 
occasionally interrupted by a strong, harsh, north-east wind, 
known as the " Tramontana," the " Aquilo " of the Ancients, 
the ill effects of which were graphically described by Celsus. 
This wind, like the " Terral " of Malaga, seldom lasts longer 
than three days, during which no consumptive or bronchitic 
patient should venture out of doors. Towards the middle of 
March sharp easterly winds generally set in, and, being 
accompanied with a hot sun and cloudless sky, are attended 
with all the ill effects of a great and sudden change of 
temperature, to which no pulmonary patient should be ex- 
posed, but should leave before this time. 

The prevailing diseases here are nervous and spasmodic 
affections and cerebral diseases, particularly apoplexy, at all 
seasons. In winter pneumonia and pleuritis are common, and 
in summer and autumn febrile disorders predominate. For 
this reason Eome should be avoided by valetudinarians from 
June to October, as malarial fevers are then endemic. 

It is almost useless to reiterate the hackneyed but well- 
founded warning to invalid visitors in Eome as to the danger 
they so recklessly expose themselves to in passing from the 



PISA AND ROME. 101 

warm and sunny streets into the chilly galleries and palaces 
which invite their inspection on every side. The only safe re- 
sort for the valetudinarian pilgrim to Eome is that mighty 
shrine — 

" — the vast and wondrous dome, 
To which Diana's marvel was a cell." 

It is a remarkable fact that, notwithstanding its vast ex- 
panse and complete shade, the atmosphere of St Peter's is 
equally genial and uniform at all seasons, and may be visited 
all times with safety by any invalid. 

In cases of chronic bronchitis and winter cough, attended 
with great irritability of the respiratory organs, constant hard 
teasing cough, and little expectoration, as well as in similar 
cases of chronic laryngeal disease and spasmodic asthma ; and 
also in chronic rheumatism, rheumatic gout, and gouty 
bronchitis, there is hardly any European climate so suitable 
for a winter resort as this. But in consumption the sanative 
influence of the Eoman climate must be admitted to be limited 
to a comparatively small number of cases, and I need not here 
repeat what I have said on this point in the first chapter of 
this work. 



102 NAPLES. 



CHAPTEE XVI 



NAPLES. 



Naples has been long esteemed as the beau idM of all that 
is beautiful in situation, or delightful in climate. "Vedi 
Napoli," says her own proverb, " e poi muori," — 

" And sooth to say who sees her will retain, 
In his mind's eye a gorgeous soil and clime, 
The last to vanish with the lapse of time." * 

The easiest and most advantageous route by which the 
invalid traveller can reach Naples is direct from Liverpool, 
London, or Glasgow, from each of which ports there are regular 
fornightly sailings by large and commodious steamers. Those, 
however, who dread crossing the Bay of Biscay may still reach 
Naples, with comparatively little fatigue, via Marseilles, in 
four days from London. The Mont Cenis route, though 
occupying only a little more than half that time, is not, I 
think, generally suitable for invalid travellers. 

As seen from the bay, Naples has been said to form a vast 
triangle, the base of which rests on the shore, and the apex 
is placed at Capo di Monte. The city is divided into nearly 
equal parts by the Via Nazionale, as the Strada Toledo is now 
called, and its continuation, the Strada Nuova di Capodimonte, 
which intersects it for close on three miles. The lower part, 

* Dr William Beattie, "The Pilgrim in Italy," Cant. 2d. 



NAPLES. 103 

formed by small narrow streets, extends towards the eastern 
side of the bay, and on the other side, which lies above, and 
parallel to the shore, towards Posilipo, contains the best 
quarters, the Chiatamone, Santa Lucia, and the Chiaja. The 
hotels, which are principally patronised by our compatriots, 
are those on the Chiaja, which, however, are expensive, and, as 
far as my experience goes, not over comfortable. Therefore I 
should recommend those who purpose spending the winter 
in Naples to procure lodgings in a good situation, or to locate 
himself in one of the numerous Pensions which may be found 
along the Eiviere di Chiaja, the Corso Vittoria Emanuele, and 
almost all the principal streets. Before deciding on a resi- 
dence, however, the invalid visitor should consult some local 
practitioner, since so great are the differences in aspect between 
the different parts of the city, that Naples has been said to 
possess two perfectly distinct climates, of which the western, 
or more elevated part is exposed to the harsh cold north-west 
wind, while the eastern side, or that lying along the plain, is 
protected from the north, but fully exposed to the relaxing, 
moist, and warm southerly winds. 

In no respect does Naples contrast so favourably with every 
other place frequented by invalids, as in the number and 
variety of resources for passing time agreeably which it 
possesses, and the opportunities which it thus affords of with- 
drawing the attention of the valetudinarian from his ailments. 
Beyond the city walls extends on every side a country 
unequalled for the beauty of its scenery, as well as in the 
historic interest attaching to each spot. And within its limits, 
nothing has been left undone by man, to adapt to his tastes 
and pleasures the paradise which nature has given him to 
inhabit. The most magnificent churches ; the most extensive 
museums, numerous palaces, libraries, — the envy of the learned 
of every land, — the most beautiful gardens ; and theatres, such 



104 NAPLES. 

as the San Carlo, the most splendid in Europe, being here 
collected together, 

The climate of Naples is dry and warm in winter, but at 
the same time is most changeable and uncertain at all seasons. 
The mean annual temperature is 61°, that of winter 48°, spring 
58°, summer 70°, and autumn 64°. Compared with Malaga 
the mean temperature of Naples is 4° lower ; that of winter 7° 
lower, spring 10° lower, summer 8° lower, and autumn 4° 
higher than Malaga. 

According to the observations of M. De Eenzi, extending 
over twenty years, the mean annual rainfall is about 29 
inches,* of which the largest proportion falls in autumn, and 
when westerly winds suddenly succeed to a south wind, as the 
atmosphere is then saturated with vapour, which is condensed 
by the cool west wind, and falls as rain. The average number 
of rainy days is about 100, of cloudy days 120, and of fine 
days about 145. 

The position of the hills, which encircle the city, protects 
Naples to some extent from northerly winds. The prevailing 
winds are, — the south-west or " Libeccio," which is often ac- 
companied by severe gales and cloudy weather; the south, 
or " Scirocco," attended by an oppressive heat, causing great 
depression of mind and lassitude of body ; the west, or 
" Ponente," during which the sky is generally serene, and the 
temperature warm in winter and cool in summer ; and the 
north-west, or "Maestro," which resembles the " Mistral " of 
Provence. 

No pulmonary patient should remain in Naples during 
the spring, whilst the cold and ungenial easterly and 
" maestro " winds are prevalent, occasioning rheumatism and 
pleurisy. The best time for such patients to inhabit Naples 
is from the end of autumn until Christmas. For those, who 

* "Topografia di Napoli," p. 57. 



NAPLES. 105 

from choice or necessity, remain, as I have done, in Naples in 
summer, the opposite shores of the bay afford a wide selection 
of cool and agreeable retreats from the heated and not very 
odoriferous atmosphere of the port and adjacent parts of the 
city. 

The frequency of sudden changes in the temperature, 
hygrometrical condition, force, direction, and pressure of the 
air, as well as the volcanic agencies in constant operation in 
the vicinity of the town, all contribute to produce an atmo- 
sphere highly charged with electricity. This manifests itself 
by the common occurrence of atmospheric perturbations, such 
as thunder storms, and in the nervous excitement and uncom- 
fortable sensations which all, and especially invalids, complain 
of at such times. 

Amongst endemic diseases, rheumatism and catarrh are 
common. Strangers are very liable to pneumonia and pleurisy ; 
and phthisis undoubtedly occasions a large proportion of the 
total mortality. 

With regard to the therapeutic application of the climate of 
Naples, it must be admitted that this city possesses great 
advantages for hypochondriacal and melancholic patients ; 
for most cases of dyspepsia; for persons suffering from 
climacteric disease, or from impaired health, the consequence 
of long residence in tropical climates. In such cases the 
mental impressions produced by the cloudless sky and 
beautiful scenery of Naples, will seldom fail to co-operate 
with the stimulating and electrical atmosphere in arousing the 
nervous energies, and exciting the action of the heart, both of 
which in these cases are generally weak and torpid. 

Tor pulmonary patients, however, and especially for con- 
sumptive invalids, Naples is not a suitable health resort. 



106 PALERMO. 



CHAPTER XVII. 

PALERMO. 

From Naples the voyage to Palermo may be accomplished in 
ten hours, by steamers starting every other day. 

Palermo is situated on the northern coast of the island, and 
is built on a well-sheltered bay, extending from the base of 
the rocky " Monte Pellegrino," on the west, to a slope of richly 
cultivated gardens, which gradually ascend to Cape Zaffarano 
on the opposite side. The plain, aptly termed by the natives 
the " La Conca d'Oro " or Golden Shell, is defended from all 
harsh and cold winds by the mountains around the city, and 
is perhaps the most beautiful, as it certainly is one of the 
most highly cultivated, valleys in Europe, not excepting even 
the Vega of Malaga. 

From the roadstead the city seems crowded with churches 
and palaces, whose tapering steeples and swelling domes rise 
above the massive fortifications that enclose the town. Along 
the beach extends the Marina, which is little inferior to the 
Chiaja of Naples. The streets are clean and regularly paved 
with lava, but offer to the stranger a picture of the close 
relationship of splendour and poverty, the immense palaces 
which adorn many of them being occupied on the ground floor 
by poor shops and cobbler's stalls. The principal thorough- 
fares, however, such as the Cassaro, or Strada Toledo and 
Strada Nuova, each over a mile in length, are handsomely and 



PALEKMO. 107 

regularly built, and intersect the town, forming by their 
junction a fine square, the Piazza Yillena. 

In no part of the world does cultivation appear to be carried 
to a greater extent than here, and nowhere does the fertility 
of the earth more abundantly repay the toil expended on it. 
The usual produce of wheat is from ten to sixteen fold, and in 
favourable years even thirty fold. Grapes are no less abun- 
dant, there being some twenty different species in the island, 
of which the most esteemed are the Muscatel and Canicula. 
The orange and lemon trees flourish in every valley, and the 
stunted olive grows almost wildly. Among the other produc- 
tions, figs, almonds, saffron, and pistacio nuts may be instanced 
in proof of the mildness of the climate. 

The mean annual rainfall in Palermo averages about 25 
inches, or 3 inches more than London. The mean annual 
temperature is 62°, or 12° higher than London, 1° higher than 
Xaples, 3° lower than Malaga, and 8° higher than Pau. The 
thermometer in the hottest days seldom rises as high as 90° 
or 92° (in shade), or falls lower than 36° even in the depth of 
winter ; and Captain Smith tells us that in one year " there 
were 121 overcast and cloudy days, on 85 of which rain fell ; 
36 misty days ; and 159 fine bright days."* 

The prevailing winds are the^northerly and westerly, both 
considered dry and healthy, and a variety of the " Mistral " 
called by the Palermitans " Mamatili," and enjoyed by them 
as an agreeable sea-breeze. Occasionally, in summer, the 
" Scirocco " prevails, and is more severely felt in Palermo than 
in any other part of Southern Europe. 

Fogs are said to be of very rare occurrence here, but I have 
seen as dense a fog as ever I witnessed off the Sicilian coast, 
so thick, indeed, was it, that our captain was obliged to lie 

* " A Memoir descriptive of Sicily and the Islands," &c, by Captain Smith, 
E.N. p. 4. 



108 PALERMO. 

to for some hours, to the great alarm of the Neapolitan pas- 
sengers. These fogs have not, however, the same depressing 
and injurious effects as ours, but are rather a thick warm 
haze, possessing singular refractive powers, magnifying and 
altering surrounding objects to a surprising extent, and 
occasionally giving rise to the celebrated spectral illusion of 
the Fata Morgana. 

The nights are generally cold, and the quantity of dew 
which falls after sunset is sufficient to compensate for the 
want of rain ; this should warn the invalid to avoid exposure 
to the night air. 

Whether the climate of Palermo be suited or not for con- 
sumptive patients, is a disputed question. But it cannot, I 
think, be doubted, that during the winter it is in some 
respects superior to Naples for such invalids. Towards the 
commencement of spring, however, cold and harsh winds 
predominate; and I know of two cases within my own 
practice that proved fatal here at this season, in both of 
which the sufferers had improved in health during the 
preceding winter at Malaga. 

I would recommend the climate of Palermo to the majority 
of dyspeptic and hypochondriacal patients, and, in fine, to 
nearly the same class of invalids to whom I stated the climate 
of Naples would probably be of service. 



MALTA. 109 



CHAPTEE XVIII. 

MALTA. 

For the British valetudinarian in search of a southern health 
resort, Malta would at first sight appear to offer peculiar 
advantages. It is certainly further to the southward than 
any other part of Europe. It is easy of access from England ; 
the expenses of living are moderate ; and all the surroundings 
of the invalid in Malta are more English than in the other 
foreign winter resorts described in these pages. But whether 
the climate is as suitable for pulmonary invalids as some con- 
tend or not, is a question which the following details will 
enable the reader to judge for himself. 

The island of Malta, which lies about sixty miles south of 
Cape Passaro in Sicily, and two hundred miles from the 
African coast, is close on sixty miles in circumference, and 
presents a rocky arid plain sloping from the south-west to the 
north-east. The geological formation of the island explains 
the almost tropical temperature which prevails here in 
summer, and the slight difference between the heat of the day 
and night at this season ; for the barren limestone rock 
absorbs the excessive solar heat during the day, and slowly 
radiates this during the night, thus equalising the temperature 
of the twenty-four hours. ' 

Valetta is situated on the western side of an elevated 
Peninsula, Mount Xiberras, between the great harbour, " Di 



110 MALTA. 

Libera Pratica," the finest natural haven in Europe, and the 

small port of Marsamuscetta. 

On landing we disembark at the famous "Nix Mangiare " 

stairs, so named from the unceasing cry of the importunate 

beggars, who here appeal to each new arrival ; and passing 

through the well-stocked fruit market ascend the long stone 

stairs that lead to the Strada Eeale, the principal street of the 

town. This runs through the whole length of the city from 

the fort at the entrance of the harbour, traversing the Piazza, 

where the palace of the Grand-Master, now the residence of 

th£ Governor, is situated, and terminating at the Porta Eeale 

or gate on the inland side of the town. The houses in this, as 

in most of the other parts of the city, are handsomely and 

regularly built of cut stone, and the streets are kept strictly 

clean. The other streets either run parallel with the Strada 

Eeale, or communicate with it by flights of steps once 

apostrophized by Lord Byron — 

" Adieu, ye cursed streets of stairs, 
How surely he who mounts them swears." 

The many public edifices and monuments of the Knights of 
St John which Valetta possesses, the cathedral, public libraries, 
university, hospitals, and fortifications, together with the 
interesting excursions that may be made into the interior of 
the island, — for instance to Citta Vecchia, or to the Catacombs 
and Grotto of St Paul, near Eabbato ; and the short and 
delightful sail to Calypso's fabled island of Gozo ; are all to be 
included among the attractions of this town as a residence for 
dyspeptic and hypochondriacal sufferers. 

Living is remarkably economical, particularly in the parts 
of the island furthest from Valetta, and though prices have 
risen considerably of late, yet still, house-rent and lodgings are 
very cheap, -and even in Valetta I was agreeably surprised at 
the small amount of my hotel bill. 



MALTA. 



Ill 



The mean annual temperature of Malta is 63°, the maximum 
90°, and the minimum within doors is 46°. According to 
Bear- Admiral Smith, the average annual rainfall here is 15 
inches ; and the average annual number of days on which rain 
falls, is sixty-eight. The following table shows the tempera- 
ture of Malta for one year, as observed at 9 a.m., noon, and 
3 p.m. daily : — 



j Maximum. 


Med. 


Minimum. 


January, . 


o 

56 


o 

534 


o 

51 


February, 




58 


554 


53 


March, 




59 


57* 


56 


April, 




62 


60^ 


59 


May, 




71 


70 


69 


June, 




75 


74 


73 


July, 




82 


794 


77 


August, 




82 


80 


78 


September, 




77 


764 


76 


October, . 




70 


694 


69 


November, 




65 


64 


63 


December, 




58 


564 


55 



The climate is, however, rendered variable, and therefore 
injurious to invalids, by the harshness and violence of the 
prevailing winds. These are the south-east or " Scirocco " and 
the north-west. The former chiefly occurs during autumn, 
and the latter prevails from December to March, and is a 
cold piercing wind laden with fine sand, and occasioning great 
discomfort, especially to pulmonary invalids. 

It is stated that the inhabitants of Malta are generally 
long-lived and healthy, and Abela adduces several instances 
of extraordinary longevity here. 

The prevailing diseases of Malta are chiefly those endemic 
in tropical countries, to the climate of which that of this island 
to some extent approximates. Fever causes a considerable mor- 
tality, and dysentery, diarrhoea, and ophthalmia are amongst 
the endemic complaints. Consumption is by no means as rare 
in Malta as might be supposed from the high temperature and 



112 MALTA. 

southern latitude of the island. At the period Dr Hennen 
wrote (and the climate has in no wise changed since then), 
it appears that one-third of the total mortality in the hospitals 
of Malta was occasioned by pulmonary diseases, of which 
consumption caused one-fourth. 

Little, however, need he said here on the therapeutic applica- 
tion of the Maltese climate, since comparatively few patients 
are now sent thither from this country. On one point, how- 
ever, I have little doubt, and that is, the utter unfitness of 
Malta for the majority of bronchitic and consumptive patients. 
My reasons for this opinion are, the great tendency of this 
climate to sudden atmospheric vicissitudes, and the frequent 
occurrence of harsh and violent winds, especially from 
December to March, when such invalids most require a warm 
and equable climate. 

B at for the numerous class of slightly ailing valetudinarians 
and imaginary invalids, for some cases of chronic rheumatism, 
scrofula, hypochondriasis, and derangements of the digestive 
organs, Malta will be as useful for a change of residence and 
change of air as any equally warm southern climate would 
be, and, moreover, possesses some collateral advantages en- 
joyed by few other of these places. 



THE CLIMATES OF EGYPT. 113 



CHAPTER XIX. 

THE CLIMATES OF EGYPT. 

Eighteen centuries ago Egypt was to the Koman physicians 
and their consumptive patients what Mce and the Eiviera 
are to ourselves at the present day. And after many ages of 
desuetude we find the ancient fame of the Egyptian health 
resorts again revived, these being now comparatively easy of 
access. Alexandria may be reached in six days from London 
via Brindisi ; or in two days longer by the Trieste route. 
Invalid travellers who are not generally pressed for time 
would seldom be served by such rapid and fatiguing journey- 
ing, and should in preference select either the passage from 
Marseilles to Alexandria, or what would be still better for 
most consumptive patients, the voyage from England by 
steamer to Alexandria in fourteen or fifteen days. 

The climate of Alexandria is peculiarly unsuitable to 
valetudinarians, and hence I shall omit any description of 
this city. With respect to the antiquities and monuments of 
Alexandria, ample accounts will be found in the ordinary 
guide-books ; and I can only advise the invalid traveller to 
devote as short a time as possible to antiquarian pursuits here, 
and to quit this pernicious climate with as little delay as 
circumstances will admit: The situation of Alexandria on a 
low sandy peniusula between the sea and the vast swamp 
known as Lake Mareotis, from which there is a continual 

h 



114 THE QLIMATES OF EGYPT. 

malarial exhalation, is sufficient to explain the remarkable 
insalubrity of this town, where fevers, dysentery and oph- 
thalmia are endemic. 

The mean annual temperature of Alexandria is about 10° 
lower than that of Cairo. During my visit in September, 
the mean daily temperature was 87°, and that summer the 
thermometer had repeatedly risen to 115° in the shade. At 
night the dew-fall far exceeds that occurring in any part of 
Europe ; so much so, that a few minutes' exposure in the 
evening is sufficient to wet a thick coat through. The 
characteristic of this climate, however, is the humidity of 
the atmosphere, in which respect the entire Delta contrasts 
remarkably with the dry climates of Upper and Middle 
Egypt. 

" In lower Egypt," says Dr R K. Madden, " the mummies 
go to pieces on exposure to external air ; and in Alexandria, 
where the air is excessively moist, I observed several mummies 
melt away in -a magazine where I kept them, and decomposi- 
tion took place after an exposure of forty hours to the humid 
atmosphere, though the same bodies had resisted corruption in 
a dry air for perhaps forty centuries.""" 

The Eev. Dr Barclay, in his valuable work on the climate 
of Egypt, says — "How far Alexandria during the months 
of March and April may be a more suitable residence for 
those whose complaints require a climate at once warm, 
equable, and moist, I leave it to gentlemen of the medical 
profession to judge ; but I do think myself fully warranted 
to denounce it as a most unsuitable place for bronchitic 
patients. During all the time I was there I felt as if inhaling 
steam ; my breathing was excessively affected, and my whole 
system was languid and relaxed. The effects, however, by the 

* "Travels in Turkey, Egypt, Arabia, and Palestine," by R. R. Madden, 
M.D., vol. ii. p. 76. 



THE CLIMATES OF EGYPT. 115 

time I had been twenty-four hours at sea, were completely 
dispelled, leaving no doubt whatever as to their cause."* 

My only reason for referring at all to the climate of 
Alexandria is that its true character does not seem to be 
sufficiently recognised in this country; for I have myself 
known instances in which consumptive patients were sent out 
to Egypt, and allowed to winter in Alexandria, in complete 
ignorance of the essential difference between the damp atmo- 
sphere of Alexandria and the perfectly dry air of Thebes. A 
mistake, of which the result was speedily fatal in one case, 
and in another proved very injurious. 

Cairo is but eight hours' journey by train from Alexandria, 
and is built on a sandy slope between the Mokattam Hills on 
the east and the Nile, which, though a couple of miles 
distant, infiltrates the loose subsoil, rendering the western side 
of the city damp and unhealthy. 

No eastern town that I have visted has retained its peculiar 
Oriental aspect so little changed as Cairo, notwithstanding 
its long - continued and daily - increasing intercourse with 
Europe. Steam and rail, which in every other land have 
advanced material civilization, at least, have in Egypt proved 
no match for the dead weight, the vis inertia of Turkish and 
Mahometan institutions. 

The visitor, having first secured his hotel, should loose no 
time in ascending to the Citadel, where he will obtain a coup 
d'ceil of Cairo worth all the descriptions ever penned. 

Below the spectator, the outlines of the city extend over an 
area of more than three miles; the tapering minarets of 
upwards of three hundred mosques rising over the flat-roofed 
houses that form the narrow lanes, through which an occa- 
sional opening affords a glimpse of the bustling bazaars, 
crowded with men clad in every variety of Oriental and 

* " The Climate of Egypt," by the Eev. Thomas Barclay, D.D., p. 63. 



116 THE CLIMATES OF EGYPT. 

European garb. The peculiar clearness of the atmosphere, 
presenting every object with a brilliancy and telescopic 
distinctness unknown in Europe. Beyond the city flows the 
mighty river, whose sources have baffled discovery from the 
days of Herodotus to those of Livingstone and Cameron. On 
the north-east are the sites of Memphis and Heliopolis, and 
further still the vast outlines of the pyramids, surrounded 
by the desert, which extends in an interminable dreary land- 
scape till lost in the distance. 

The city is divided into quarters named after the class who 
reside in each. The hotels are chiefly situated in the Franks' 
quarter in the square of Esbekieh, and for the most part 
are immense half-furnished buildings. When the charm of 
novelty has worn off by a few days' stay, and the Citadel, 
bazaars, baths, and mosque of Sultan Hassan have been 
visited, Cairo contains nothing else to interest the tourist. 

It has been stated by recent writers, that the modes of 
travelling are now so improved in Egypt, that every invalid 
who goes to Cairo may easily and safely visit the Pyramids. 
Being anxious, however, to prevent valetudinarians from 
falling into this mistake, I venture to extract from my journal 
an unvarnished account of a visit to the pyramids. 

September 5th. — Having provided myself with a guide, and 
escorted by three Arabs, I started from Shepard's Hotel at nine 
o'clock at night, and in less than an hour's time arrived at Old 
Cairo, where, as the new bridge over the Nile was not then 
open, we aroused a sleeping ferryman who, indignant at his 
slumbers being interrupted by a kick in the gluteal region from 
the guide, refused to carry us across the river at any price. 
A long and angry discussion now ensued ; in the midst of 
this altercation a guard of soldiers appeared, who, with perfect 
impartiality,- marched us all, bystanders as well as combatants, 
off to the guard-house, some half-mile distant. 



THE CLIMATES OF EGYPT. 117 

A small bribe having been judiciously administered by the 
guide, the officer on duty ordered the boatman to cross the 
river forthwith, and sent a soldier to enforce the injunction. 
We got on board, but as some fatality would have it, a new 
dispute now arose ; the ferryman demanding ninety piastres, 
the usual charge being eighteenpence. Again the soldier was 
appealed to, and promptly settled the matter, for, entering 
the boat, to my horror, he commenced belabouring the man 
with the flat of his sword, accompanying each blow with 
sundry valedictory remarks on the ancient ferryman's deceased 
parents. This course proved very efficacious, for the price now 
fell to six shillings ; and thus, finally, we crossed, having lost 
above an hour in the dispute. 

As we passed through Ghizeh we encountered two mar- 
riage processions, the performers in which seemed almost 
mad with excitement. 

Escaping "rfroni these we passed at once into the silent 
country, which, brilliantly lighted up by the full moon, and 
covered as far as the eye could reach by the inundation, now 
at its height, seemed to be a vast inland sea, only intersected 
by the narrow serpentine causeway on which we rode, and 
along which, every now and then, we passed by groups of 
fellahs lying asleep, this being the only dry ground about. 

Soon after leaving the village the pyramids appeared in 
sight; their vast proportions, exaggerated by the uncertain 
moonlight, seemed close at hand. We now left the causeway, 
and at last entered on the dry sands of the desert, through 
which our donkeys struggled, plunging up to their knees. 
At length we arrived at the mound of rubbish which lies 
before the grand pyramids, weary and exhausted, at two 
o'clock in the morning. 

Having lighted our torches, we squeezed through the nar- 
row aperture on the north side, following the guide ; and, as 



118 THE CLIMATES OF EGYPT. 

cautiously as possible, on hands and knees, slipped along the 
steep shaft, not above three feet square, which descends to 
the base of. the Pyramid. From this, now semi-asphyxiated, 
and rendered incapable of actively climbing the slippery 
passage, we were pushed by the guide along a gallery of 
marble polished to a glassy smoothness ; which, after a 
time, expands into a lofty corridor, where I enjoyed the 
luxury of raising my face from the ground without risk of 
fracturing my cranium, though it was so steep that standing 
was still out of the question. I now got into the sarcophagus 
chamber, which assuredly did not compensate for the fatigue 
of the approach. The glimmering light dimly disclosed a 
vast apartment of granite, with a broken sarcophagus in the 
centre, profusely disfigured by the hieroglyphics of Messrs 
Brown, Jones, and Eobinson, et hoc genus omne," some of 
whom have, with infinite pains, traced their illustrious 
patronymics with the smoke of a flambeau on the roof of 
the chamber. 

The descent proved more facile than the entrance, and 
resisting the persuasive voice of the guide, who would have 
me visit another apartment, I struggled back again through 
the same aperture by which I had entered into the open air, 
where I arrived more dead than alive, and wrapping my cloak 
about me sank on the ground in a sleep of complete 
exhaustion. I lay thus for a couple of hours, which seemed 
scarcely as many minutes, until the guide warned me that 
it was time to be stirring. Having first visited the Sphinx, 
we started on our return at about half past-five in the 
morning, and got back to Cairo in time for a late breakfast, 
steadfastly resolving never again to visit the Pyramids of 
Ghizeh. 

The mean annual temperature of Cairo is 70° and, according 
to the observations of Mons. Destouches, a French chemist, in 



THE CLIMATES OF EGYPT. 119 

the employment of the late Pasha, the mean temperature of 
the months is as follows : — 









o 




o 


January, 


. 55 


May, . 


. 77 


September, 


76 


February, 


. 59 


June, . 


. 82 


October, 


75 


March, 


. 64 


July, . 


. 84 


November, 


66 


April, 


. 71 


August, 


. 84 


December, 


59 



It is only during the cool season, from October to the end 
of March, the mean temperature of which is 62°, that invalids 
can visit Cairo, as, during the rest of the year, the climate is 
so hot and arid as to be unendurable to foreigners. 

Even in the depth of winter the weather in Cairo is as 
mild and genial as in the latter part of spring in this country ; 
the lowest temperature usually observed being in the middle 
of January, when it sometimes falls to 37°. At all seasons 
however, there is here a remarkable diminution of tempera- 
ture after night-fall, often amounting to a difference of from 
20° to 30° between the maximum of the day and the minimum 
of the night. This is attributed to the fall of dew, to the 
influence of the north wind, and, above all, to the extra- 
ordinary clearness of the atmosphere, favouring the radiation 
of heat from the earth. 

During eight months of the year cool northerly winds 
prevail in Cairo. But from March to the middle of June 
southerly winds, from the heated sandy plains of Central 
Africa, are most frequent. One of these — the " Khamsin " — 
is a perfectly dry scorching south wind, generally lasting for 
fifty days continuously. During this time the lungs of those 
exposed to the " Khamsin " are irritated by the impalpable 
sand suspended in the air, which is then in a highly electrical 
condition. The thermometer rises from 30° to 50°, and a 
feeling of malaise, langour, and depression is produced 
rendering any great exertion almost impossible. 

With one exception, no health resort frequented by English 



120 THE CLIMATES OF EGYPT. 

invalids has so dry a .climate as Cairo, where the number of 
rainy days observed seldom exceeds twelve annually. There 
is, however, a heavy dew-fall at night. The atmosphere is 
peculiarly dry and devoid of any free humidity. The 
difference between Alexandria and Cairo in this respect may 
be inferred from the fact that the atmosphere of the latter 
city contains 152 times less moisture than the former. 

A large number of invalids are now annually sent to winter 
on the Nile, most of whom suffer from chronic bronchitis or 
consumption. This practice might at first sight be thought 
a very mistaken one, when we learn that catarrhal affections, 
scrofula, and tubercular diseases are common in Egypt, where, 
moreover, phthisis occasions a large proportion of the total 
mortality of the native population. Whether consumption 
is, or is not, one of the prevailing diseases of Egypt, matters 
little, however, to foreign invalids, who only visit this country 
at the most healthy period of the year, and whose hygienic 
condition and general circumstances are entirely different 
to those of the native population, amongst whom phthisis 
certainly prevails. 

According to the classification proposed in the introduction, 

Cairo must be placed in the same category with the dry, 

stimulating climates of Malaga, Hyeres, or Nice, possessing 

/\ these qualities in a much more marked degree than any of 

those localities. 

To that large class of patients in whom incipient phthisis is 
insidiously progressing to its fatal issue, in young persons of 
phlegmatic temperament, about the age of puberty, the climate 
of Middle Egypt offers a resource only second in value to 
a long sea voyage. Cairo would also generally be a good 
winter resort in cases of humoral asthma, in some instances of 
the disease so well described by Dr Dobell under the name 
of " winter cough," chronic laryngeal affections, and in some 



THE CLIMATES OF EGYPT. 121 

cases of chronic bronchitis, and characterised by relaxation 
and debility. But Cairo should be particularly shunned by 
those who are suffering from pulmonary disease, accompanied 
by a hard dry cough, a tendency to congestion of the lungs, 
and, above all, by those disposed to haemoptysis. 

When consumption has advanced to the second stage, 
there are very few cases in which the climate of Cairo, or 
that of any part of Egypt, would be advisable ; and when the 
disease has reached its third and last phase, I would add, it is 
generally most unsuitable, although I have more than once 
seen consumptive patients who were almost moribund, sent out 
to winter, or rather to die, on the Mle. 

Invalids should arrive in Cairo towards the end of October, 
and be prepared to leave it about the middle of March, before 
the unhealthy and debilitating southerly winds set in. 

Upwards of thirty years ago, my father, Dr E. E. Madden, 
in his " Travels in the East," and Dr Eichardson, in his 
" Travels in Nubia," published nearly at the same time, were 
amongst the first who pointed out the advantages of the 
climate of Upper Egypt for invalids, and the number of 
valetudinarians who have resorted thither of late years, and 
the testimony of recent medical writers, have confirmed the 
correctness of their opinions. 

Unfortunately, however, Upper Egypt is only available for 
those who have sufficient youth and strength to endure the 
many inconveniences of boat life on a semi-tropical river, and 
amidst a semi-civilized people. The number is still further 
limited by the great expense which such a journey entails, so 
that, unfortunately, none but the wealthy can avail themselves 
of this, the driest and purest atmosphere in the world. 

The railways from Enibare to El Eoclah, and from Abouxa 
to El Eayoum and El-Wasta, are practically useless to travel- 
lers for health in Upper Egypt, there being no proper accom- 



f 



122 THE CLIMATES OF EGYPT. 

modation for foreign invalids at any station in the valley of 
the Mle beyond Cairo, so that such persons must still visit 
this country in a boat, on board which they must live during 
their stay in Upper Egypt. 

For ordinary tourists, the Khedive Government Steamers, 
which start from the new bridge " Kasr-el-Ml " at Boulac, the 
port of Cairo, at regular intervals every fortnight, now afford 
great facilities for an expeditious and comfortable trip as far as 
the first cataract. The voyage from Cairo to Assouan and back 
occupies about twenty days, the steamers stopping each night 
at some village, and affording opportunities for visiting Abydos, 
Thebes, Luxor, Karnack, Edfou, and nearly all the places of 
interest on the river between Cairo and the first cataract. 
This journey, which may be thus accomplished for £46, 
although a most interesting and facile one, by no means meets 
the requirements of the pulmonary invalid traveller, occupying 
far too short a time, and not extending to the part of Egypt 
the climate of which is most suitable for such persons, namely, 
that portion of the Mle valley which lies between Assouan 
and the second cataract. Hence, the pilgrim in pursuit of 
health in Egypt must in most cases still follow the old plan 
of river life on the Mle in a Dahabeah or large sailiug-boat. 
Eor this purpose he should arrange with a dragoman at 
Alexandria or Cairo, who will undertake to provide a good 
boat fitted up for passengers, with an efficient crew, and 
suitable accommodation for the passengers at so much a head 
per diem ; and for a party of five or six persons, who usually 
club together for such a tour, the expense to each individual 
would be about £50 a month. 

The atmosphere of Upper Egypt, especially between 
Assouan and the second cataract, is unquestionably the 
driest resorted to by pulmouary invalids ; the natural 
evaporation from the river being more than counteracted by 



THE CLIMATES OF EGYPT. 123 

the prevailing arid winds from the adjacent desert. Professor 
Uhle, who passed a winter on the Nile, says, — " After ascend- 
ing beyond 29° latitude the temperature rose 5° higher than it 
then was at Cairo. February is here the coldest and driest 
month; and as the spring advances, and the river falls, the 
atmosphere becomes still drier." 

In a therapeutic point of view, Upper Egypt may be 
regarded as a very perfect example of a tonic, dry, warm and 
exciting climate, and I have already pointed out, in the first 
and second chapters, the cases for which such an atmosphere 
is adapted. Amongst these I may especially mention the 
early stage of phthisis and chronic bronchitis, with profuse 
and exhausting secretions, and occurring in persons of a torpid 
leuco-phlegmatic temperament, who have been brought by 
disease into an anemic condition. Those disposed to conges- 
tive diseases, especially of the brain, should avoid Upper 
Egypt. 

In every part of Egypt the invalid traveller should avoid 
the night air as he would poison ; for there is, immediately 
after sunset, generally a sudden and dangerous transition, 
from the hot atmosphere of the day, -to a chill night air, 
generally accompanied with a fall of dew so profuse as to 
supply the want of rain. 



PART SECOND. 

THE SPAS AND THEIR USES. 



CHAPTER XX. 

PRELIMINARY OBSERVATIONS ON THE SPAS. 

It would be difficult to point out a class of remedies which 
have so wide a range of therapeutic action on disease, and 
which are resorted to in so great a variety of cases, as mineral 
and thermal waters. The list of ailments, however, which 
may be benefited by the spas, would be as long and as 
uninteresting in this place as the " catalogue of ships" in 
the Iliad. 

Most of those whom we meet at the watering-places are 
patients suffering from some form of indigestion, or from 
diseases occasioned by the gouty and rheumatic diathesis. 
These, with cases of nervous, cutaneous, and scrofulous affec- 
tions, constitute the great bulk of the spa-drinkers. But 
besides persons labouring under actual disease, a large propor- 
tion of the patients at the watering-places suffer from no 
tangible malady, although obviously " out of health." 

Among the throng of pilgrims to these fountains of Hygeia, 
come youth and age — the fagged beauty, after a season, in 
search of that bright complexion and those roseate hues which 
cosmetics cannot counterfeit ; legislators and professional 
men ; the votaries of science and of fashion ; the man of 



PRELIMINARY OBSERVATIONS ON THE SPAS. 125 

business and his more laborious rival in the race of sanitary 
destruction, the lounger about town, — all Hadgis to the shrine 
of health. 

In many of these cases, when a course of some foreign 
mineral water is enjoined, the cure which results is due not 
only to the active therapeutic properties of the spa prescribed, 
but also to the fact, that during the course nature enjoys 
a respite from that incessant drugging for which many 
valetudinarians have so unaccountable a predilection. 

Another advantage of prescribing mineral waters is, that an 
opportunity is thus given for taking the invalid away from 
those habits of life which are often closely connected with his 
ill-health, and which, unless they are interrupted and 
abandoned for a time, will prevent the patient's cure. Besides 
this, if a distant watering-place be selected, the journey, the 
change of climate, of scene, and of living, often exercise a 
most potent therapeutic action of themselves. Lastly, it 
supplies an opportunity for mental rest, which is not idleness, 
but change of thought. 

Irrespectively of these moral, and indirect curative effects, 
most of the spas described in the following pages are, per se, 
medicinal agents of extraordinary therapeutic power, many of 
them being as potent for evil when misused, as for good when 
properly employed, and should never be resorted to without 
judicious medical advice. 

In the succeeding chapters I have, in the first place, 
endeavoured to lay before my readers a succinct view of the 
nature and uses of mineral and thermal waters. I have next 
referred to the various diseases that may be treated by the 
springs, and pointed out the mineral water adapted to each 
particular case. And, finally, I have described the principal 
watering-places of continental Euiope from my personal 
observations and notes taken at each spa. 



126 NATURE AND REMEDIAL EFFECTS OF 



CHAPTEE XXL 

. ON THE NATURE AND REMEDIAL EFFECTS OF MINERAL AND 
THERMAL WATERS. 

Mineral springs are those which contain saline ingredients 
in such quantities, or in such combination, as to possess 
medicinal properties. They are classified into groups which 
bear some general resemblance in chemical composition or 
therapeutic action. A considerable number of the spas, 
however, are so complex in their character, that it would 
be difficult to say which ingredient so preponderates as to 
determine their nomenclature on chemical principles. More- 
over, we find some waters containing only a trace of any 
chemical ingredients producing well-marked remedial effects. 
If, on the other hand, we base our plan of classification on the 
therapeutic properties of the spas, we shall be equally liable 
to error, since the same waters occasion widely opposite 
effects, according to the doses they may be taken in, the 
condition of the patient, and a great variety of other circum- 
stances. 

Therefore, putting aside a strictly chemical classification 
of mineral waters as chimerical, and passing over ; for the 
present, the division sometimes adopted of the spas, from 
their medicinal effects, I shall consider the various springs 
described in the succeeding chapters as divisible into chaly- 
beate, sulphurous, saline, iodated, earthy, and chemically 
indifferent mineral springs. Of these some are cold, and 
others thermal. The former contain a larger amount of 
gaseous and saline ingredients than the latter, and have 



MINERAL AND THERMAL WATERS. 127 

generally a comparatively superficial origin in subterranean 
streams, formed by trie atmospheric water absorbed by 
elevated mountain districts ; and are forced up to the surface 
by hydraulic pressure, dissolving and becoming charged 
with the soluble salts contained in the various strata they 
percolate in the transit, or with gases resulting from chemical 
decomposition, the chief of which are sulphuretted hydrogen 
and carbonic acid gases. 

The effects of mineral waters are, in many instances, de- 
pendent on the amount of carbonic acid gas they contain, 
which not only produces physiological effects itself, but also 
renders substances, otherwise insoluble, capable of being 
dissolved. Thus, chalybeate spas, for example, are resorted 
to or neglected, not so much on account of the amount of 
iron they contain, as on the volume of carbonic acid gas by 
which it is rendered digestible and active. 

Numerous theories have been advanced to account for the 
phenomena of thermal or warm medicinal springs ; and per- 
haps the most satisfactory of these is that which supposes 
their connection with volcanic action. In some places 
thermal springs issue in the immediate vicinity of active 
volcanoes. In other cases we find proof that volcanic agency 
once played an important part in the configuration of the 
neighbouring country. Such are given by the basaltic 
formations from which the Brunnens of the Taunus Moun- 
tains, the sources of Pfeffers, and the warm springs of the 
high Pyrenees issue. A still more evident proof of the 
relation between volcanic action and thermal springs is 
furnished by the fact, that direct communication seems to 
have been clearly established between earthquakes occurring 
in one country, and the hot springs of distant lands. This 
was more particularly the case during the great earthquake of 
Lisbon in 1755, when the springs of Teplitz in Bohemia, 



128 NATUKE AND REMEDIAL EFFECTS OF 

Natres in Savoy, and Leuk in Switzerland, were simul- 
taneously affected. 

Chalybeate Waters may be divided into simple and saline 
ferruginous springs. The former of which, Orezza in Corsica ; 
Pyrmont, Driburg, Schwalbach, and Briickenau, in Germany ; 
Auteuil and Passy within the fortifications of Paris ; and 
Spa in Belgium, are examples, contain little else than 
the carbonate of the protoxide of iron, dissolved in water 
more or less highly charged with carbonic acid, and are 
therefore not only tonic but stimulant in their effects, excit- 
ing the nervous, circulating, and digestive functions, as well as 
increasing the red corpuscles and fibrine of the blood. 

The saline chalybeates, which generally contain some of 
the soluble salts of soda, together with the iron, are chiefly 
employed in similar cases to the saline springs when marked 
with debility, and in anaemia, complicated with abdominal 
disease, whether resulting from long residence in tropical 
climates, or from dietetic errors. Amongst these are the 
Stahlbrunnen of Homburg, Booklet in Bavaria, Franzensbad 
in Bohemia, Cronthal and Eippoldsau in Germany, Saratoga 
in the State of New York, Tunbridge Wells, Scarborough, and 
Cheltenham in England. 

Sulphurous Springs are those whose medicinal constitutents 
are sulphuretted hydrogen gas and the sulphurets of sodium 
or potassium. Warm sulphurous waters are invariably 
stimulant in their effects on the nervous, as well as on the 
vascular systems. The principal sources of this class are 
Aix-la-Chapelle, Aix-les-Bains, Baden in Switzerland, Baden 
near Vienna, Burtscheid, Schinznach, Teplitz, and Warrn- 
brunn in Germany, Penticosa in Aragon, Carratraca, on the 
road from Malaga to Bonda, in Andalusia, and Caldas da 
Eainha in Portugal. The Pyrenean mineral springs nearly 
all belong to the same division of thermal waters. 



MINERAL AXD THERMAL WATERS. 129 

The action of these spas is more intimately dependent on 
their temperature than on their chemical composition, being 
more stimulant the hotter they are. The warmer springs are 
chiefly used in gouty and rheumatic complaints, in chronic 
skin diseases, especially eczema, prurigo, psoriasis and 
syphilitic eruptions, neuralgia, and scrofulous, glandular, and 
arthritic swellings. The cold sulphurous springs, such as 
Langenbrticken, Nenndorf, and Weilbach in Germany ; 
Bex and Schinznach in Switzerland ; Castel Jaloux, Castera- 
Yerduzan, Enghien-les -Bains and Plombiers in France, and, 
nearer home, Lisdoonvarna and Harrowgate, being less stimu- 
lant, are safer, though less active in their general use, and may 
be employed in analogous cases to the former. Such mineral 
springs, however, whether hot or cold, should never be used 
when there is any tendency to inflammation or even conges- 
tion of any important organ, especially of the brain or lungs, 
and they must be most sedulously avoided in all cases in 
which haemorrhage is to be apprehended. 

Muriated Saline Springs are those whose active constituent 
is chloride of sodium or common salt. Wiesbaden, Baden- 
Baden, Bourbonne-les-Bains, Hammam-Melouane in Algeria, 
Cannstadt, and Soden are thermal waters of this class, and 
Kissengen, Homburg, and the saline sources of Cheltenham 
and Leamington are cold. They stimulate the gastro-intestinal 
mucous membrane, act upon the bowels, augment the amount 
of urea discharged by the kidneys, increase the elimination 
of effete tissues, and are employed in the treatment of gout, 
rheumatism, scrofula, dyspepsia, habitual constipation, and 
torpidity of the liver. 

Saline, Alkaline Waters chiefly contain sulphate and bi- 
carbonate of soda. Carlsbad, Marienbad, Franzensbad, and 
Tar asp are examples of this class of mineral springs. Their 
action being purgative and deobstruent, they are prescribed in 

I 



130 NATURE AND REMEDIAL EFFECTS OF 

abdominal plethora, habitual constipation, hepatic enlarge- 
ments, and gouty dyspepsia, 

Muriated Alkaline sources are those in which chloride of 
sodium, with carbonic acid gas and bicarbonate of soda are 
the main ingredients. Ems, Salzbrunn, aud Selters belong to 
this category, which are all diuretic, aperient, and antacid. 
Their use is indicated in the gouty diathesis and dyspepsia, 
certain diseases peculiar to women, hysteria, renal and hepatic 
affections. 

Simple Alkaline Springs, such as Vichy and Vals in France, 
Fachingen, Geilnau, and Bilin, in Germany, and Chaves and 
Vidago in Portugal, contain bicarbonate of soda with excess 
of carbonic acid gas. By the use of these spas the blood is 
rendered more alkaline, the various excretory functions, espe- 
cially diuresis, are increased, and the appetite is sharpened. 
They are chiefly used in gout and rheumatism, also in gouty 
dyspepsia, and in renal calculi, and gravel connected with the 
uric acid diathesis. 

The Bitter Waters are those containing a large proportion 
of the sulphates of magnesia and soda. The most important 
of these springs are Piillna, Saidschiitz, and Sedlitz in 
Bohemia; Hunyadi-Janos in Hungary ; Birmenstorf in Switzer- 
land ; Friedrichshall in Saxe-Meiningen ; the saline wells of 
Ashby-de-la-Zouch in Leicestershire, Epsom in Surrey, and 
Beulah at Sydenham, may be included in the same class of 
mineral springs as the German Bitterwassers, acting like 
them as saline cathartics, and being also diuretic and 
derivative. 

Earthy Springs are impregnated with sulphate, carbonate, 
and chloride of lime, and carbonic acid They are in general 
thermal, Wildugen, Leuk, Lippspringe, Weissenburg, Bath, 
Lucca, and Pisa, belong to this class of waters, the action of 
which is astringent and stimulant. Wildugen, which con- 



MINERAL AND THERMAL WATERS. 131 

tains free carbonic acid, is also diuretic, and is useful in 
gravel and diseases of the bladder. Leuk is chiefly resorted 
to by patients suffering from skin diseases. Bath, Pisa, and 
Lucca are used in gout, rheumatism, cutaneous affections, and 
dyspepsia. 

Jod-und-Bromhaltigen Koclisalzwasscr, as the Germans call 
springs containing iodine and bromine, generally owe their 
properties to iodide of sodium and bromide of manganese in 
a muriated saline water. Nearly all such sources are cold. 
The principal waters of this class are Kreuznach, Adelheids- 
quelle, Hall, Salzhausen, and Elmen in Germany; Wildegg 
in Switzerland ; and Wood hall Spa in Lincolnshire ; the last 
named being probably the strongest iodated spring in Europe. 
Taken internally, these waters stimulate the mucous mem- 
branes, occasion ptyalism and diuresis, promote absorption, 
and quicken the appetite. They are ordered in scrofulous 
diseases, especially of the glands and joints, in chronic 
glandular enlargements, such as bronchocele, in secondary 
syphilis, and, above all, in the treatment of some of the 
diseases peculiar to women, connected with chronic uterine 
or ovarian inflammation, 

The so-called chemically indifferent springs, such as Schlan- 
genbad, Teplitz, Gastein, Neuhaus, Tiiffer, and Wildbad in 
Germany, Chaudefontaine in Belgium, and Pfeffers in Switzer- 
land, are thermal sources, some of which contain absolutely 
less mineral matter than our ordinary drinking water. Thus, 
the New Eiver water contains 2 J grs. of solid matter to 
the pint ; the East London Company 3 grs. ; and that supplied 
by the Hampstead Company 4J grs. Yet these waters cause 
no apparent effect, whilst the springs of Wildbad, with 3J grs. 
of salt to the pint ; Pfeffers and Gastein, 2 grs. ; and Chaude 
fontaine, with 2J grs., are all capable of producing therapeutic 
results, which seem to be mainly due to the temperature at 



132 NATUEE AND BEMEDIAL EFFECTS OF 

which they are employed. These chemically indifferent baths, 
especially the cooler ones, possess peculiarly sedative effects, 
not only allaying nervous irritation, but also diminishing 
vascular excitement, whilst the warmer springs of the same 
class, being more stimulant, are chiefly used in aggravated 
cases of chronic rheumatism and rheumatic-arthritis . 

We may now proceed to consider the therapeutic applica- 
tion of these various mineral waters, which is by no means 
solely determined by their chemical composition, as is sup- 
posed by some able chemists ; one of whom goes so far as to 
assert that it is only necessary to ascertain what are the saline 
ingredients in any mineral water, " and dissolve the same con- 
stituents in the proper proportions, and you regenerate the 
spa to all intents and purposes." I presume, however, that the 
" intent and purpose " of the invalid who resorts to any spa is 
the cure of some ailment ; and most assuredly this will not 
be accomplished by the " simple method " of the chemist. 
The baths of Wildbad, for instance, contain only two grains of 
common salt, with half a grain each of carbonate and sulphate 
of soda to the pint of water, at the temperature of 98° ; and 
yet wonderful cures of chronic arthritic diseases are effected 
by a course of them. But very few practical physicians could 
be persuaded that an artificial solution of the same salts 
would produce the same effects. If it had the same influence, 
would it not be as absurd as cruel to send a patient, crippled 
by chronic rheumatism, to a remote village in the Black 
Forest, when a handful of common salt, with a teaspoonful of 
washing-soda and Epsom salts, would convert a tub of luke- 
warm water in his own bedroom into a verjungen, or " youth- 
restoring fountain ? " 

Without entering into the much disputed question of the 
mode of action of chemically indifferent and other mineral 
waters, concerning which many German writers seem to revel 



MINERAL AND THERMAL WATERS. 133 

in explaining the ignotum per ignotius, each successive 
' Brunnenartz ' putting forth some conjecture if possible more 
misty and unintelligible than that of his predecessor, I believe 
that we may content ourselves with the empirical knowledge 
that certain mineral waters produce certain effects. In many 
instances these waters act simply as so much pure water 
would do could it be swallowed under the same circumstances, 
and with the same anticipation of success which mineral 
waters are used with. When we consider the amount of 
water consumed daily by each patient at most spas, we will 
find that as diluents these waters must have* a considerable 
action on the animal economy. Ten or twelve pints of 
mineral water per diem is a common dose at several of the 
spas, and it is obvious that the mere passage of so large a 
quantity of fluid through the system must break down and 
wash away morbid deposits and disordered secretions. The 
effects of the journey to the spas are oftentimes sufficient to 
account for the benefit ascribed to the mineral springs. The 
mode of life at most continental spas is usually totally dif- 
ferent from the ordinary habits of the British valetudinarian, 
who is forced into earlier and more regular hours, and into 
taking more exercise than he has been accustomed to; and 
this change is probably one of the most important advantages 
of the foreign watering-places. 

The majority of those who resort to the continental water- 
ing-places suffer from disorders connected with the gouty 
diathesis, or with some gastric derangement. Now, travel as 
we may, whether we " rough it " on foot through the mountain 
bye-roads of Switzerland or Spain, or sedulously avoid fatigue 
in the sleeping-car of a train, more or less exercise must be 
taken ; and oftentimes it is this exercise which does the good 
ascribed to the mineral water or change of climate. By it the 
circulation is quickened, but at the same time is equalised ; 



134 NATURE AND REMEDIAL EFFECTS OF 

that is, all the vessels receive more blood, and thus the 
amount accumulated in any one organ is diminished. The 
respiration is also hurried, and therefore more carbon is 
exhaled from the system. The appetite is sharpened. The 
change of diet, the freer use of fruit, the light acidulous wines, 
the oleaginous cookery, all promote the alvine and renal ex- 
cretions. The " moral " influence of the change, too, con- 
duces to the physical improvement it effects. New scenes 
and places suggest new thoughts ; the atrabilis of gloomy 
apprehension is purged away, and the patient, ceasing to 
think on his symptoms, they cease to exist. 

Still I am very far from asserting that change of living and 
scene will of itself produce all the benefits often effected by a 
journey to, and use of, an appropriate spa. No amount of 
travel will, unaided by other treatment, purify the vitiated 
blood of a gouty patient, reduce to proper proportions a 
tumefied liver, unbend a contracted joint, or impart vigour to a 
palsied limb, all of which cures are oftentimes performed at 
the spas. 

Though most of the saline constituents of mineral waters 
are articles of the Pharmacopoeia, and generally exist in com- 
paratively small quantities in the spas, yet they act more 
effectually, owing to a more perfect solution and finer division 
of the natural preparation than can be effected by artificial 
means. Another reason of this superiority is, that spas 
occasionally contain substances insoluble in ordinary water. 
The Homburg springs, for instance, contain carbonates of 
lime, iron, and magnesia, and silica, which are rendered 
soluble by the presence of free carbonic acid gas. 

The mode of using, and dose of the spas, depends on the 
composition of the particular spring selected, the condition of 
the patient, and a variety of circumstances, which render it 
impossible to lay down any accurate general rules on these 



MINERAL AND THERMAL WATERS. 135 

points. • Still I shall attempt a few suggestions which may be 
found useful. 

In the first place, mineral waters should, if possible, be 
drank at their source. The patient who uses the imported 
mineral waters sold in this country, not only loses the chief 
benefit of the prescription, that is, the change of scene, of 
climate, and of living, but further, the mineral fluid is in 
most cases changed and deteriorated by keeping. 

The spa physicians, as a rule, advise their patients to dis- 
regard all other medicines, and confide in the virtues of the 
mineral water 'of their place of abode. It would be rather 
difficult to say whether this recommendation has done most 
harm or good. In many cases it is, doubtless, a wholesome 
counsel. But, on the other hand, when the patient is really 
ill, the use of mineral waters should not supersede all other 
treatment ; for, as a very observant English physician of the 
last century well remarked, " it is but prudent to bring all the 
forces one can raise against so formidable and so potent an 
enemy as a chronical disorder."* 

The quantity of water to be consumed is a matter that 
should be prescribed to the patient before he is sent to the 
spa, and must be determined by the circumstances of each 
case. Invalids are generally left to their own discretion on 
that point, and seldom exercise any. Not a few valetudi- 
narians think that the benefit to be derived is in exact pro- 
portion to the amount of mineral water they can swallow. 
As a rule, two glasses of water before breakfast, one before 
dinner, and a couple of tumblers-full in the evening are quite 
sufficient. 

In cases of structural cardiac, pulmonary, or cerebral 
disease, mineral, and especially thermal waters are generally 

* Cheyne, "An Essay on the Gout and the Bath Waters," p. 59, London, 
1721. 



136 NATUEE AND REMEDIAL EFFECTS OF 

worse than useless. Consumptive patients are constantly 
sent to certain spas, and we are assured that cures are thus 
effected. My own belief, founded on the study of this 
disease in many climates is, that no case of phthisis 
was ever cured by any mineral water, although the general 
health of phthisical patients may probably sometimes be 
benefited by a course of light chalybeate or alterative waters. 

Natural warm or thermo-mineral baths may be divided into 
two groups, the first of which have a temperature ranging from 
85° to 97,° or lower than that of the blood; and the second 
comprising all the baths whose heat exceeds this. The 
effects produced by baths of the former kind are of a sedative 
character ; after a few minutes immersion the nervous system 
is soothed, pain and irritation are allayed, a feeling of physical 
comfort and tranquillity is induced ; the functions of the skin, 
however, become more active, the various secretions are 
increased, and changes are produced in the blood, by the 
transudation and absorption that take place in the bath, 
which are greatly influenced by the chemical composition and 
density of the water. 

The principal maladies treated by baths of this class 
are — chronic nervous and spasmodic affections, such as 
neuralgia and sciatica, subacute disorders of the abdominal 
and pelvic viscera, especially of the liver and gastro- 
intestinal mucous membrane. This remedy is especially 
applicable to the treatment of many of the diseases of 
women connected with chronic inflammation of the uterus 
or ovaries, in some cases of painful or defective men- 
struation; and in hysteria dependant on these causes. 
Thermal baths are also largely and successfully employed 
in rheumatic affections; and, finally, these baths are used 
with remarkable success in the treatment of. chronic skin 
diseases. 



MINERAL AND THERMAL WATERS. 137 

The second class of thermal baths comprehends all those 
whose temperature is higher than that of the blood, and 
ranges from 98° to 120°. Such baths are strongly stimulant, 
their exciting power being in proportion to the elevation of 
their temperature. The blood is determined to .the surface 
by them, the cutaneous capillary vessels become congested, 
the respiration is hurried, the pulse is accelerated and becomes 
full and throbbing, and a sense of oppression and discomfort 
is felt until a profuse sweat relieves the circulation. When 
this has broken out, all the uneasy sensations gradually 
disappear, and are succeeded by a sense of languor and 
exhaustion, with a tendency to sleep. 

Widely spread as they are throughout Europe, the 
therapeutic uses of hot mineral baths is limited to a small 
class of patients. They are employed in certain obstinate 
cutaneous affections, in chronic rheumatism, and rheumatic 
arthritis. 

The length of time the patient should remain in the bath 
depends on the nature of the mineral water, and on that of 
his disease, and varies from ten minutes, which is the usual 
period of immersion at some of the hotter sulphurous baths, 
to eight or ten hours, which formerly at Pfeffers was thought 
an ordinary occurrence. 

The ordinary duration of a bath at Wildbad, Aix-les- 
Bains, Gastein, and several other places, is an hour. So 
prolonged an immersion in a fluid at the same temperature as 
the blood stimulates the cutaneous capillaries, withdraws the 
blood from internal congested organs, allows their vessels to 
recover their healthy tone and contractile power, and must be 
capable of producing powerful curative results. 

Care should be taken to avoid exposure to cold immediately 
after leaving the warm bath, and therefore I think that the 
very early hour at which the bath is generally taken at the 



138 MINERAL AND THERMAL WATERS. 

spas of Germany is open to some objections ; and in many 
cases it will be found better to bathe in the middle of the 
day three or four hours after breakfast, or in the evening, 
about five or six hours after the early German dinner. 

Whenever a patient exhibits any apoplectic tendency, hot 
mineral baths are most dangerous, and might lead to sudden 
and fatal results. Very fat people should be equally cautious 
of indulging in such baths. In all cases, too, in which the 
heart, aorta, or any important vessel is diseased ; and, indeed, 
whenever it is necessary to guard against vascular excitement, 
thermal mineral waters are contra-indicated. 



DYSPEPSIA AXD THE SPAS. 139 



CHAPTEE XXII. 



DYSPEPSIA AXD THE SPAS. 



With the exception of the maladies produced in this climate 
by wet and cold, most of the diseases for which health resorts 
are visited are the result of an excessive or injudicious diet, — 
'.' plures crapula quam gladius." The object of the present 
chapter is to show that most of these complaints, including all 
cases of dyspepsia whose leading symptoms are impaired, or 
fastidious appetite, painful, slow, or imperfect digestion, irregu- 
lar action of the intestinal canal, and hypochondriasis, may be 
better treated by mineral waters, conjoined to abstinence, or 
some alteration of living, than by pharmaceutical preparations. 
On no subject whatever have more numerous and con- 
tradictory systems been propounded than on diet, and on none 
would it be more utterly impossible to lay down any 
universally useful general rules than on this. The majority 
of people eat far more than nature requires, and far more than 
they can assimilate ; and, consequently, very few enjoy perfect 
health. But the number of meals and the quantity of food 
consumed can only be decided by each individual's experience 
of what agrees with himself; for some would gain flesh on 
Carnard's allowance of eleven ounces of food per diem, whilst 
others would starve on as many pounds. Therefore the only 
rule I would venture to recommend to the dyspeptic patient 
is that, putting aside the bugbear of debility, he should use 



140 DYSPEPSIA AND THE SPAS. 

only the quantity of food he can digest, without pain or 
discomfort, however small this may be. 

Although we have progressed vastly from the bibulous habits 
of our grandfathers, still, to the present day, far too much 
wine is used by the upper classes in .this country, and many 
of the ailments by which life is embittered, and premature 
death induced, and to ward off which the spas are resorted to, 
are owing to this cause. Wine and all other alcoholic liquors 
are quite unnecessary to a man in perfect health ; but com- 
paratively very few are to be found in that happy state. If 
we lived in a world in which no sorrows, cares, or anxieties of 
the mind, reacting on its frail tenement the body, produced 
diseases, and paved the way to death, then would I join those 
who preach total abstinence from all intoxicating drinks. 
But as, unfortunately, we live on earth, and not in Utopia, 
and have to fight the battle of life often against unequal 
odds, with failing strength and sinking heart, therefore, with 
Solomon, would I prescribe — " Wine to him that is ready to 
perish, and to him that hath grief of heart." Two or three 
glasses of wine daily, however, are quite sufficient for any 
adult, and under no circumstances whatever should wine be 
given to a child, except as a medicine. 

To treat dyspepsia, we must bear in mind its causes ; and 
these, besides errors of diet, are severe mental labour, conjoined 
to a sedentary life, nervous excitement and anxiety, the abuse 
of tobacco or tea, and late and irregular hours. These must 
all be corrected, and a journey to, and residence in a distant 
watering-place, will often prove the most efficacious mode of 
effecting this. The travelling, with its concomitant change of 
scene and of climate, benefits the patient's general health, 
takes his attention from his ailments, and thus proves an 
antidote to the gloomy and depressant influence of dyspepsia. 
The early and regular hours observed at the continental spas 



DYSPEPSIA AND THE SPAS. 141 

are a wholesome contrast to the late hours of fashionable life, 
where the example of Srnyndiris, the Sybarite, who for twenty 
years never saw the sun rise or set, is very frequently 
followed. Lastly, the mineral waters themselves are remedies 
more powerful than any prepared by the apothecary in the 
treatment of indigestion and hypochondriasis. 

Most of the spas resorted to by dyspeptic invalids are saline 
springs, of which Soden, Homburg, Wiesbaden, and Kissingen 
are perhaps the most generally employed. Occasionally the 
more stimulating and cathartic springs, such as Franzensbad, 
Carlsbad, and Marienbad, exert a happy influence on derange- 
ments of the liver connected with indigestion. Often, when 
this is obviously dependent on nervous debility and weakness, 
the chalybeate saline waters are indicated ; but so protean are 
the forms of indigestion, that it would be impossible here to 
enlarge on this topic, Whatever spa may be chosen, the 
patient should be taught to depend more on his own self- 
control than on the mineral water for his cure. 



142 GOUT AND ITS TREATMENT BY MINERAL WATERS. 



CHAPTEE XXIII. 

ON GOUT AND ITS TREATMENT BY MINERAL WATERS. 

Although an elaborate disquisition on the gout would be 
misplaced in a work of this kind, still a few preliminary 
observations on the disease appear to me necessary for under- 
standing the action of certain spas in its cure. 

Formerly gout was deemed a sign of wealth, and even of 
a vigorous intellect. Thus Sydenham remarks that " gout 
destroys more rich than poor, and more wise men than fools." 
Whatever may have been the case then, at present, however, 
gout attacks rich and poor with impartiality ; and were it con- 
fined to the wise alone, the fees of gouty patients would, I 
fear, be considerably diminished. The fact is, that whenever 
people of any class indulge largely in animal food and 
fermented liquors, gout will prevail; though, of course, the 
injuLy caused by the excessive use of azotized articles of diet 
will be less in proportion to the amount of exercise or labour 
performed. But though the gout may be produced or 
engendered in almost any individual by certain habits of 
living, more frequently it is the result of hereditary trans- 
mission. A tendency to gout or the gouty diathesis, descends 
for generations ; and the inheritor of these tendencies, unless 
he use precautions very few submit to, when he attains 
middle age, will experience the effects of his own and his 
ancestors' indiscretions in a fit of the gout. 



GOUT AND ITS TREATMENT BY MINERAL WATERS. 143 

An attack of regular gout is generally preceded by gastric 
derangement, diminished excretions, languor, groundless de- 
pression of spirits and great irritability of temper. When 
such symptoms occur in a man of full habit of body, beyond 
the middle age, and especially if he be of gouty parentage, 
we may safely conclude that podagra will declare itself in a 
few days. If nothing be done to stave off the approaching 
seizure, after three or four days' slight indisposition the patient 
may go to bed in his usual condition, and awake from a sound 
sleep to suffer the torture of acute gout. For some nights 
the pain and febrile disturbance recur, though with less 
severity, the cuticle peels off, the urine becomes more copious, 
depositing lithic salts, and the attack gradually wears away. 
The interval which now elapses before the next seizure after a 
first fit of gout will probably last a year, but becomes shorter 
after each recurrence, until at last the invalid is hardly ever 
free from the disease. 

Besides what is known as the regular gout, the disease 
in question plays a protean part in the chronic ailments of 
the richer classes in this country. We meet every day 
patients who have never complained of gout, but who in point 
of fact are never free from that disease. These persons are, 
for the most part, men of enfeebled constitution, of a sallow, 
cachectic complexion, with a rough, dry skin, an irregular, 
often feeble and compressible pulse, scanty excretions, variable 
appetite, complaining of frequent heartburn and uneasiness in 
the right hypochondrium, of irritable disposition, and despon- 
dent temperament. In this gouty habit of body, mineral 
waters offer the most appropriate remedy. 

In every age satirists have found a subject for ridicule in 
the multiplicity and uselessness of the remedies employed 
for the treatment of gout. Ovid emphatically asserts that — 
" Tollere nodosam nescit medicina podagram." 



144 GOUT AND ITS TREATMENT BY MINERAL WATERS. 

Nor was .Fenton, who died himself from this disease, more 
complimentary to the power of physic when, in his " Ode to 
the Gout/' he addresses it as — 

" Thou that dost iEsculapius deride, 
And o'er his gally-pots in triumph ride." 

Sydenham very tersely sums up all the remedies used for 
gout in his day, and, though a hundred and eighty years have 
elapsed since, his conclusion is still to some extent apposite. 
He says — " In gout, too, but three methods have been proposed 
for the ejection of the causa continens— -bleeding, purging, 
sweating. Now none of these succeed." But during an 
acute paroxysm of gout, it is seldom easy for the sufferer to 
content himself with flannel and patience ; and, fortunately, 
a great deal maybe done in most cases in the way of mitigat- 
ing the pain, and expediting the recovery. Herein lies the 
skill of the physician. The charlatan treats all cases alike, 
and, as an old writer well expresses it, — " Sometimes he kills 
the disease ; but more frequently he kills the patient." 

We now come to the treatment of gout by mineral waters. 
It is obvious, however, that this treatment can only be used 
as a prophylactic, or in the intervals between the paroxysms. 
By the proper use of mineral waters we open avenues 
through the excretory organs for the elimination of those 
principles whose presence in the blood gives rise to the 
phenomena of gout. The secretions from the intestinal 
mucous membrane, kidneys, and skin, are all augmented; 
and through these channels the gout-producing lithates are 
washed away. When the constitution is weakened, by 
repeated seizures of gout, chalybeates are often required ; 
and in such, cases the superiority of nature's pharmacy to that 
of art is shown ; for oftentimes, when every preparation of 
steel has been tried without benefit, some of the mild chaly- 



GOUT AND ITS TREATMENT BY MINERAL WATERS. 145 

beate springs " work wonders," restoring tone and strength ; 
and thus it is that Schwalbach, Spa, or Tunbridge Wells 
prove useful, by giving strength to the system, to localise and 
develop regular podagra, in the stead of that misplaced, atonic, 
irregular, wandering form of gout now so prevalent. 

The carbonated alkaline springs, such as Vichy, Bilin, 
Fachingen, and Geilnau, are most commonly prescribed in the 
intervals of regular gout. They correct the acidity of gouty 
blood, rendering it and the urine alkaline, facilitate digestion, 
and increase the secretions. The simple saline or muriated 
saline springs are also largely employed in gouty cases, and 
especially in gouty dyspepsia. They stimulate the appetite 
and digestion, and thus improve the blood. Their effects 
vary according to their temperature, some of them being cold 
and others thermal. Homberg, Cheltenham, and Kissingen 
belong to the former, and Wiesbaden, Baden-Baden, Soden, 
and Cannstadt are examples of the latter. The saline alkali tie 
spas, such as Carlsbad, Marienbad, and Franzensbad, are 
occasionally useful in cases of irregular gouty disease in 
persons of full plethoric habit. 

Of the English spas resorted to by gouty sufferers, perhaps 
the most generally applicable are the warm saline waters of 
Bath ; next rank those of Buxton ; then the chalybeate-salines 
of Cheltenham and Tunbridge Wells. 

Whatever may be the mineral water selected in the treat- 
ment of any case of gout, it should be borne in mind that its 
curative influence must be aided by the same abstemious 
and guarded mode of living which the patient would have 
required had he been treated at home. 



K 



146 MINERAL WATERS IN THE TREATMENT OF 



CHAPTEE XXIV. 

ON MINERAL WATERS IN THE TREATMENT OF SOME OF THE 
DISEASES PECULIAR TO WOMEN. 

The importance of constitutional remedies, and the efficacy 
of certain mineral waters in the cure of most of the diseases 
peculiar to women, are subjects which I have elsewhere 
discussed, and I now venture to reiterate very briefly my 
views on these points. 

Within a comparatively recent period the diseases and 
displacements of the uterus have come to occupy the most 
prominent place in the etiology of female diseases, and it 
may be fairly asked, whether these complaints have really 
become more common than was formerly the case ? Or, is it 
merely the fashion of the present day to ascribe all obscure 
female ailments to uterine causes ? Or, have these been 
always as prevalent, though only now discovered by the 
improved means of diagnosis furnished by modern gynaeco- 
logical science ? 

Uterine complaints are certainly more in vogue as well as 
more easily diagnosed than was the case a few years ago. 
But irrespective of this, however, they must also be admitted 
to be more prevalent; owing, as I believe, mainly to the 
increasing luxury of the present age, and the artificial habits 
and conditions of modern life, producing gout, and, indirectly, 
scrofula — the most frequent, although generally unrecognised, 
causes of the diseases peculiar to females. 



DISEASES PECULIAR TO WOMEN. 147 

Uterine specialists may be considered as followers of one or 
other of three distinct schools of gynaecology. A few years 
ago most of the diseases peculiar to women were commonly 
attributed to inflammation of the cervix uteri; then newer 
view r s as to the frequency and pathological importance of 
ovarian disease in such cases prevailed; and, lastly, the 
doctrine that these complaints are the result of displacements 
and flexions of the uterus has come to be widely adopted as 
the only sure foundation of uterine therapeutics ; 

" For in physic, as in fashion, we find 
The newest has always the run of mankind." 

Each of these theories is undoubtedly applicable in many 

instances, but neither of them holds that exclusive and 

primary place in the causation of the diseases peculiar to 

women which some writers insist on. 

From my own experience, I would say that the most fre- 
quent immediate cause of impaired female health is chronic 
uterine, or utero-ovarian inflammation. Thus, rather more 
than one-tenth of all the patients under my care at the Dis- 
pensary for Diseases of Women suffered from endo-metritis 
or cervicitis, and in private practice I have found the propor- 
tion of these cases fully as large. The consequences of chronic 
inflammation of the womb and its appendages are as important 
as its frequency. In some instances chronic metritis occasions 
hypertrophy and ulceration of the cervix and os uteri, vagin- 
itis and leucorrhcea ; in others congestion and enlargement of 
the fundus, eventually causing flexions and displacements of 
the womb ; and in others again it extends to the ovaries, pro- 
ducing menstrual irregularities, sterility, and hysteria in all 
its forms. 

Sterility almost always accompanies this disease, and as 
long as it exists to any serious extent the patient must 
remain barren. This fact, which I regard as one of great 



148 MINERAL WATERS IN THE TREATMENT OF 

importance, is too generally ignored in practice. I have 
known instances in which patients were subjected to very 
heroic surgical treatment to overcome some supposed mechani- 
cal obstacle to impregnation, and who nevertheless remained 
childless, no attention having been paid to the true and most 
frequent cause of sterility, namely, the existence of chronic 
inflammation, on the subsequent cure of which pregnancy has 
immediately followed. 

Ovarian inflammation, manifested by soreness, tumefaction, 
and occasionally burning pain in the ovarian region, is one of 
the most common consequences and accompaniments of endo- 
metritis. In these cases the inflammation extends from the 
uterus, along the Fallopian tubes to the ovaries ; and hence 
patients thus affected are sterile for the time being. 

The treatment of the affections now under consideration is 
still vague and unsatisfactory, generally extending over long 
periods of time and often unrewarded by the -cure of these 
diseases, their predisposing causes being, as I believe, over- 
looked in practice. 

Of the predisposing causes of chronic inflammation of 
the uterus, by far the most frequent is the scrofulous diathesis. 
Some years ago I observed, and called attention to the 
fact, that a large proportion of the patients attending the 
Dispensary for Diseases of Women were of a well-marked 
strumous habit of body, or actually suffered from glandular 
or cutaneous scrofulous affections. In such cases uterine 
complaints are necessarily impressed with the constitutional 
taint. 

Women are supposed to be in a great measure exempt from 
gout. This opinion is certainly unfounded with regard to 
anomalous gout, which attacks women quite as much as men ; 
and, in the former, affects the uterus as commonly as regular 
gout does the joints in the latter. There is no reason why 



DISEASES PECULIAR TO WOMEN. 149 

the gouty diathesis should be confined to men. Gouty 
parents generate female as well as male children; any 
hereditary disposition must be shared in by both alike, and 
the exciting causes of the disease are obviously not limited 
to either sex. 

Many of the symptoms which Gooch described under the 
name of irritable uterus, and which modern gynaecologists 
have transferred to the account of displacements of that organ, 
are oftentimes produced by gout, and may occur independently 
of any mechanical cause, though they may also coexist with it. 
Thus, in a paper on this subject, which I published some time 
ago in the Lancet, I instanced the case of a widow lady, aged 
about thirty, who had for years been suffering from lumbar and 
pelvic pain, extending down the left thigh, and accompanied 
with lameness, dysuria, and slight uterine catarrh. The cervix 
uteri was congested and the os patulous, the sound penetrated 
five inches, and the fundus was tilted backwards. Before she 
consulted me she had been treated by others for retroversion by 
mechanical expedients only, and for a long time I did the 
same. Every pessary, — and the number was almost countless 
that I tried, — however well it mighb fit, was practically useless: 
before a week's time she would limp into ray study in as bad 
a plight as ever. I need not go through the details of the case 
further than to add, that I learned at last that she inherited 
gout, and, on examining, found her urine laden with uric acid. 
She was then treated by alkaline remedies and colchicum, 
and sent to Vichy, whence she returned with all the symp- 
toms relieved, and, though yet necessitated to wear a Hodge's 
pessary, is practically free from any discomfort. 

With regard to active local treatment in ordinary cases of 
chronic inflammation and simple ulceration of the os and 
cervix uteri, Talleyrand's advice might be advantageously 
adopted by gynaecologists — " Surtout point de zele." If we 



150 MINERAL WATERS IN THE TREATMENT OF 

trusted more to constitutional remedies, and above all to the 
judicious employment of certain mineral waters, in such cases, 
I verily believe that in many instances our patients would 
get well sooner than they do, when the local irritation is 
increased secundum artem, by frequent examinations and the 
repeated application of escharotics. 

In considering the uses of mineral waters in cases of 
impaired health connected with chronic inflammation of the 
uterus and its appendages, we should in the first place 
recognise the fact that local treatment, although not to be 
neglected, should be subordinate to the cure of the consti- 
tutional disease which is the remote, and too commonly 
the undetected, cause of the local complaint. Thus, in 
scrofulous or gouty uterine disease, the faulty state of the 
blood should be corrected by alteratives and tonics, or by 
antacids, and above all by the natural chalybeate and iodated 
mineral waters, or by the alkaline carbonated spas, as the 
case may be. 

Hysteria in some form is generally associated with chronic 
uterine disease, and this underlies and complicates most of 
the symptoms for which gynaecologists are consulted. Coun- 
terfeiting every malady, acting through and upon the nervous 
system, attended with groundless apprehension, depression of 
spirits, and morbid irritability of temper, oftentimes rendering 
the patient herself as miserable as she renders those about her, 
this disease is closely allied to that graver nervous lesion 
which constitutes insanity, and, if unchecked, may pass into 
it. Local treatment, except to rectify some displacement 
or subdue well-marked ovarian or uterine inflammation, is 
of little utility in such cases ; nor are the tonics and anti- 
spasmodics -usually relied on, comparable in their thera- 
peutical effects in restoring a hysterical woman to the Mens 
sana in corpore sano, to the saline chalybeate waters, such as 



DISEASES PECULIAR TO WOMEN. 151 

Ems, Schwalbach, or Spa, provided these be used at their 
source. 

The use of a remote spa in these cases is something be- 
yond the benefit to be derived from the mineral water. 
The functions of the liver and bowels, commonly torpid in 
hysterical women, are stimulated by the change of living, and 
a sedative effect is generally produced on the hypersesthetic 
condition of the patient. The changes and incidents of the 
journey suggest new ideas, by which the patient's mind is 
diverted from that morbid concentration on her ailment which 
characterises hysteric disease. 

Amongst the mineral waters that may be employed in the 
treatment of chronic uterine complaints, the iodated and 
bromated saline springs, such as Wildegg, Woodhall-Spa, 
Kreuznach, Adelheidsquelle, Hall, and Salzhausen, deservedly 
hold the foremost place. These waters act as special stimu- 
lants to the mucous membranes and glandular system, pro- 
mote absorption, occasion ptyalism and diuresis, quicken the 
appetite, and produce the resolution of glandular enlarge- 
ments. Hence their singular efficacy in the treatment of the 
diseases of women produced by chronic uterine enlargements 
and hypertrophy, the result of congestion or chronic inflam- 
mation of the womb ; and especially in these cases of sterility 
which are supposed to be occasioned by hypertrophy of the 
cervix uteri. 

The second class of mineral waters applicable to the treat- 
ment of the chronic uterine diseases now under consideration 
are the chalybeates, both simple and saline. The former are 
those most resorted to by sufferers from chronic diseases of 
the womb, and are especially adapted for the treatment of 
chronic ulceration of the cervix uteri and uterine or vaginal 
leucorrhcea, associated with anaemia, as well as in the consti- 
tutional debility and loss of tone so frequently produced by, 



152 MINERAL WATERS IN THE TREATMENT OF 

as well as conducive of, uterine irritation, [inflammation, 
congestion, or ulceration. Chalybeate spas also exercise a 
marked curative action in cases of hysteria dependent on 
these causes, as well as in certain instances of sterility. The 
principal simple chalybeate waters suitable for such cases on 
the Continent are Spa, Pyrmount, Briichenau, Schwalbach, 
and Driburg. 

The saline chalybeate springs may also be used in various 
forms of chronic uterine disease producing anaemia and com- 
plicated with abdominal andother enlargements, and, accord- 
ing to my experience, are particularly serviceable in the 
uterine disorders so commonly caused in European women 
by tropical climates, and especially by long residence in 
India. These springs generally contain the salts of soda in 
combination with iron, and amongst them those most suitable 
for the cases we are now considering are the Stahlbrunnen of 
Homburg, Franzensbad, Booklet, and at home, Tunbridge 
Wells and Cheltenham. 

Sulphurous mineral waters are the third class which I 
regard as applicable for the treatment of the uterine diseases 
above referred to. Thermal sulphurous spas being strongly 
stimulating, can only be used in cases where the patient's 
constitutional state is not plethoric, and where there is no 
clanger of enkindling latent inflammation, and thus converting 
a chronic into an acute disease. The warm sulphurous springs 
that are available for the treatment of chronic inflammation of 
the womb are Schinznach in Switzerland, Baden on the 
Limmat, Aix-les-Bains, Eaux-Bonnes, and Amelie-les-Bains. 
Cold sulphurous waters, such as Lisdoonvarna, Harrowgate, 
Enghein-les-Bains, and Plombiers, may also and with greater 
safety be employed in some cases of chronic uterine inflam- 
mation. 

Whenever uterine and ovarian dysmenorrhcea, pain, or 



DISEASES PECULIAR TO WOMEN. 153 

any other evidence of inflammation is present, ■ there are no 
remedies of such universal applicability as the chemically 
indifferent thermal baths, such as those of Pfeffers, Schlan- 
genbad, Gastein, Wildbad, and Chaudfontaine, all of which 
exercise a powerful sedative effect on the nervous and 
vascular systems, and are especially suitable for cases of 
uterine disease associated with hyperesthesia and hysteria, 
or abnormal nervous susceptibility. Besides these, the ther- 
mal arseniated waters of Mont Dore and St Nectaire, both in 
the volcanic district of Auvergne, may be used in uterine 
disorders of scrofulous or neuralgic origin. The warm mineral 
waters of St Sauveur, in the Eastern Pyrenees, which, in 
addition to their high temperature, contain a large amount 
of the peculiar pseudo-organic unctuous substance termed 
" glairine " or " baregine," have a great and, I believe, well- 
merited reputation in France in the treatment of scrofulous, 
rheumatic, and neuralgic affections, as well as in hysteria, 
leucorrhcea, and other complaints peculiar to women, resulting 
from chronic uterine disease. 

It can hardly be necessary for me to observe that, although 
I attach so much importance to the constitutional treatment 
of uterine maladies, which, I believe, is too generally over- 
looked at the present day, I am by no means insensible of 
the equal importance of conjoining efficient local treatment 
with the constitutional remedies indicated in such cases. 



154 CHAUDFONTAINE. 



CHAPTER XXV. 

CHAUDFONTAINE. 

The first Belgian spa on the route from England to the Bhine 
is Chaudfontaine, and if facility of access, beauty of situation, 
and convenience of living were the chief recommendations for 
a watering-place, then should Chaudfontaine be among the 
most frequented spas of Europe. 

Chaudfontaine may be easily reached in fourteen hours from 
London ; but I should myself be very loathe to travel with 
the man who on any but the most urgent necessity would 
thus rush through Belgium, of which the majority of health 
travellers, armed with through tickets from Victoria or 
Charing Cross to Homberg, or whatever German spa they 
intend to visit, now generally see little or nothing. For my 
own part, I love to loiter along the ancient streets of Bruges 
or Ghent, or, losing my way in the quaint winding thorough- 
fares of Antwerp, to stray through its glorious cathedral and 
churches. Therefore I confess that I cannot relish being shot 
by express train from country to country in the cannon-ball 
fashion of travelling now so much in vogue, and more 
particularly through a country like Belgium, where every 
town — nay, every village — presents remains of historic interest 
that can be found in no other part in Europe. 

Within a quarter of an hour's journey of Liege, in the 
valley of the Vesdre, surrounded by beautifully wooded hills, is 



CHAUDFONTAINE. 155 

the village of Chaudfontaine, consisting of a long straggling 
street of small hotels and lodging-houses. Immediately 
opposite to the railway station is the thermal spring, bath- 
house, and assembly rooms. This source belongs to the class 
of chemically indifferent springs, owing its effects chiefly to 
its temperature, which is 92° ; the saline ingredients contained 
in a pint of the water being but a grain and a half of common 
salt, and rather less carbonate of lime. 

The physiological effect of the Chaudfontaine baths is 
sedative. The duration of these baths should not exceed 
twenty minutes, and they are principally employed in cases of 
neuralgia, chronic rheumatism, and contractions of the joints 
from this cause. I can also recommend their use in some of 
the diseases peculiar to women depending on uterine or 
ovarian hyperesthesia, congestion or chronic inflammation, 
and more especially in some forms of painful and imperfect 
menstruation. The internal use of this water is also resorted 
to as an adjuvant to the baths, which are contra-indicated in 
all cases in which any tendency to haemorrhage exists. 

One great defect in these bath-rooms is their imperfect 
ventilation, so that they become filled with steam which, con- 
densing on the walls, runs down in a stream on the bather's 
garments. The season commences in May, but the most 
crowded month in Chaudfontaine is July. 



156 spa. 



CHAPTEE XXVI. 

SPA. 

Of all the foreign chalybeate mineral waters resorted to by 
English valetudinarians, the most accessible as well as some 
of the most efficacious are those of Spa. This watering- 
place, which is separated from London by only sixteen hours 
of easy journey, is charmingly situated in a valley in the 
Ardennes Hills, by which it is sheltered from northerly and 
easterly winds. The town itself is merely an aggregation of 
hotels and lodging-houses, together with a few shops, as the 
resident population is barely four thousand people, who 
contrive to live by supplying the wants of the thirty thousand 
visitors who annually drink these waters. 

Spa is one of the most enjoyable watering-places on the 
Continent. The beauty of the surrounding scenery and the 
many easy and picturesque walks and drives in the imme- 
diate vicinity render this place peculiarly adapted for 
hypochondriacal and dyspeptic valetudinarians ; whilst those 
who do not consider open air exercise in a fine climate and 
amidst beautiful scenery a sufficient enjoyment, will find in 
Spa a theatre open on Sundays, Tuesdays, and Thursdays, a 
public ball on Wednesdays and Saturdays, and a concert on 
Mondays and Fridays, during the season. 

The living at the hotels — of which there are some twenty- 
four — is better than at most of the Continental watering- 



SPA. 



157 



places. The small mutton of the Ardennes is equal to the 
Welsh, and the neighbouring streams furnish an abundant 
supply of excellent trout, carp, and roach. 

The season lasts from the first of May until the end of 
September, when the weather generally becomes cold and 
broken. 

The Spa waters are powerful chalybeates containing, in 
addition to the carbonate of the protoxide of iron, a large 
volume of free carbonic acid gas. Hence their action, not 
only tonic but stimulant, and their use in the treatment of 
almost all chronic diseases of an anaemic character in 
which chalybeates are indicated. 

Analysis of the principal Mineral Springs of Spa. 



Sources. 


d 

2 

33 
P< 
S 


G c3 " 


*!§ 

T3 .— - 3 


«4-< 0> 

a x rZ 

trig 


o 

11 

e3 


o 

s s 

o 


o 

3 


Is 

J33P 

E3^ 


03 




H 


^o 




o-S 


o 




O 


o 




Pouhon, 


50 


21 


3-37 


0-87 


075 


0-20 


0-90 


0-31 


0-28 


Geronstere, 


49 


14 


1-65 


0-45 


0-33 


0-09 


0-45 


0-16 


o-io 


Sauveniere, 


49 


20 


1-70 


0-43 


0-22 


0-06 


0-30 


o-io 


0-07 


1st Tonnelet, . 


49 


22 


0-96 


0-39 


0-15 


0.04 


0'21 


0-08 


0-04 


2d Tonnelet, . 




19 


0-58 


0-25 


0-12 


o-oi 


0-08 


0-06 


0'02 


Groesbeck, 




21 


0-83 


0-24 


0-16 


0-04 


0.22 


0-08 


0-04 



The Pouhon, which is the mineral source par excellence of 
Spa, as it contains twice as much saline ingredients as any of 
the other springs, and is the only one exported, is situated in 
the centre of the town. It rises through a handsome marble 
basin, around which each morning a crowd of valetudinarians 
congregate, struggling to reach the presiding Naiades, two 
ancient females who deal out the water in exchange for a 
few sous. The spring issues from a soft ferruginous slaty 
rock ; is clear and sparkling, and though chalybeate is 
decidedly piquant and agreeable in taste. 

Besides cases of simple amenorrhcea connected with anaemia 



158 spa. 

and chlorosis, the Pouhon may be used by patients whose eon-' 
valescenee after childbirth has been slow and imperfect. 
This spring is especially recommended by Dr Sutro "in 
obstructed portal circulation, in deficient bilification, in con- 
gested liver and spleen, following intermittent fever ; also in 
flatulency, digestive weakness and acidity, tendency to 
diarrhoea and passive haemorrhage."* It is also occasionally 
employed in cases of dropsy supervening on acute diseases, 
and it was in this malady that Peter the Great, a pompous 
inscription to whose memory adorns the " Temple de Pouhon," 
found the Spa waters so efficacious. 

A mile and a half distant from the town is the source de 
Barisart. This spring, though weaker than the Pouhon in 
saline constituents, contains a larger volume of carbonic acid 
gas, and may be prescribed with greater advantage in some 
instances of extreme debility after recovery from fever, and in 
certain cases of hepatic obstruction and also in uterine catarrh, 
resulting from chronic endo-metritis of scrofulous origin. 

One of the most interesting sources of this watering-place, 
at least to gynaecologists, is the Sauveniere, which is situated 
about half a league to the south-east of Spa. The Sauveniere 
water is saline, ferruginous, and acidulated. It is very sparkling, 
containing nearly twice as much carbonic acid gas as the 
Pouhon. The chief use made of the Sauveniere is in treat- 
ment of sterility in anaemic women, who frequently derive 
extraordinary benefit from this water, By the side of the well 
is the form of a shoe deeply engraved in the rock, and tradition 
asserts, and ladies believe, that whoever quaffs a glass of the 
Sauveniere standing, with her right foot in the " pied de St 
Eemacle," will within the year augment the population. 

A few yards from the Sauveniere is the Groesbeck spring, 

* " Lectures on the German Mineral Waters," by Siguismnnd Sutro, M.D., 
p. 327. 



spa. 159 

so named from some Baron de Groesbeck, who, very wisely 
foreseeing that posterity might otherwise ignore his exist- 
ence, in 1771 put a tablet over the fountain, commenting 
on its virtues and his own. This water is lass ferruginous 
and saline, though more gaseous, than any of the other springs. 

The last of these mineral sources that I visited were the 
three Tonnelets, so named from the wooden receptacles in 
which the water was originally collected. 

The " Tonnelets " are by far the most agreeable of the Spa 
waters, and one of them was not inaptly described by an old 
writer as being — " most grateful, subacid, vinous, smart, and 
sprightly, not unlike the briskest champagne wine, imparting 
exceedingly little, if any, vitriolic or ferruginous taste. Being- 
drank, it generally sits lightly and agreeably on the stomach, 
and though exceedingly cold, it warms, cheers, and invigorates."* 

* "An Essay on Waters," by C. Lucas, M.D. of Dublin, vol. ii. p. 199, 
London, 1756. 



160 AJX-LA-CHAPELLE. 



CHAPTEE XXVII. 

AIX-LA-CHAPELLE AND BORCETTE. 

Interesting as are the reminiscences attaching to Aix-la- 
Chapelle, a very brief notice will suffice of this place as a 
modern spa. 

Aix-la-Chapelle, or Aachen, is situated some thirty miles to 
the south of Spa, at the foot of a range of well-wooded hills of 
no great height. Like most of the watering-places, Aachen 
consists of an old town immediately around the wells, and a 
modern suburb in which the invalid visitors pitch their 
quarters, as far away as the extent of the place will allow of 
from the waters they have come to make use of. This latter 
portion occupies the upper part of the town on the Borcette 
or south side, extending from the theatre to the railway 
station ; and in it the streets are wide, clean, rectangular, dull, 
and uninteresting. 

The springs are divided into upper and lower, of which the 
former are the hottest. The " Elisenbrunnen " is situated 
midway between the old and new town, close to the theatre, 
and issues forth under a handsome colonnade, where the water 
drinkers promenade, in the intervals between their potations, 
from five until eight o'clock in the morning, and again in 
the afternoon. 

I am indebted to my friend Dr Velten for the following 
tables, which show that, in addition to the substances pre- 



AIX-LA-CHAPELLE. 



161 



viously found in them, these springs contain iron, potassa, 
iodine, and bromine. 

Composition of the Aix-la- Chap elle Sulphur Waters. 



Not Volatile Ingredients. 


Emperor's 
Spring. 


Cornelius 
Spring. 


Rose 
Spring. 


Quirinus 
Spring. 


Chloride of sodium, . 
Bromide of sodium, . 
Iodide of sodium, 
Sulphuret of sodium, 
Carbonate of soda, . 
Sulphate of soda, 
Sulphate of potassa, 
Carbonate of lime, . 
Carbonate of magnesia, 
Carbonate of iron, 
Silica, 

Organic substance, . 
Carbonate of lithia, . 
Carbonate of Strontian, 






2-63940 
0-00860 
0-00051 
0-00958 
0-65040 
0-28272 
0-15445 
0-15851 
0-053 47 
0-00955 
0-06611 
0-07517 
0-00029 
0-00022 


2-46510 
0-00360 
0-00048 
0-00544 
0-49701 
0-28664 
0-15663 
0-13178 
0-02493 
0-00597 
0-05971 
0-09279 
0-00029 
0-00019 


2-54588 
0-00360 
0-00049 
0-00747 
0-52926 
0-28225 
0-15400 
0-18394 
0-02652 
0-00597 
0-05930 
0-09151 
0-00029 
0-00027 


2-59595 
0-00360 
0-00051 
0-00234 
0-55267 
0-29202 
0-15160 
0-17180 
0-03346 
0-00525 
0-06204 
0-09783 
0-00029 
0-00025 


Sum of the non-volatile co] 


itents 




4-10190 


3-73056 


3-89075 


3-96968 



The medicinal effects of these waters depends, however, in a 
great measure, on the amount of sulphuretted hydrogen gas 
they contain, and which is here combined with a larger 
amount of nitrogen than in any other European sulphurous 
sources. From the preceding table we learn that there is no 
real difference between the springs, which only vary in 
temperature according to their position with respect to their 
common source. 

There is a chalybeate spa in the Theater Strasse, with a 
bathing establishment attached to it, the water of which is 
cold, and is said to contain half a grain of iron to the pint ; 
but the resident physician with whom I visited the springs of 
Aix-la-Chapelle attached little therapeutic importance to this 
source, which some consider as fictitious. 

The mineral waters of Aix-la-Chapelle, though decidedly 
sulphurous, are seldom rejected by even the most fastidious 
stomach. Nay, strange as it seems that a fluid whose flavour 
is that of the washings of a dirty gun-barrel should ever be 

L 



162 AIX-LA-CHAPELLE. 

palatable, I observed that after the first day or two the 
majority of the water drinkers at the Elisenquelle appeared 
positively to enjoy their matutinal potations. 

The action of this spa is that of a stimulant, operating 
principally on the kidneys and skin. This determination to 
the surface and renal organs explains the efficacy of the water 
in many cutaneous diseases, glandular enlargements, biliary 
obstructions, atonic dyspepsia, renal complaints, uterine 
derangements, impaired health from metallic poisoning by 
mercury or lead, and in cases of lurking constitutional 
syphilis. The mineral waters of Aix-la-Chapelle are also 
prescribed in cases of chronic rheumatic-arthritis, rheumatism, 
and sciatica; and Dr Velten informs. me that he has seen 
benefit derived from their use in some forms of chronic 
bronchitis and catarrh. 

Fully two-thirds of the invalid visitors to Aachen, as far 
as I could judge, suffer from cutaneous eruptions, or from 
chronic rheumatism. In these diseases the internal use of 
the water is combined with baths, which, indeed, are the chief 
part of the treatment here. The principal baths are the 
" Bains de la Eose," in the Comphausbad Strasse, which are 
supplied from the lower source, and are well arranged and 
comfortable. The douche is peculiar; the attendant enters 
the water with the bather, and turns on the full force of the 
hot steam, through the hose, on the affected parts, kneading 
and rubbing them diligently with his disengaged hand at the 
same time. The temperature of these baths is 116°. 

The course of the Aachen baths and waters is usually six 
weeks, and few can continue it longer, as the effect is so 
debilitating that most patients can only use the douche twice a 
week, and, at the end of a course, even when cured of their 
original complaint, generally require a short course of some 
chalybeate water. 



BORCETTE. 163 

Before leaving Aix-la-Chapelle we visited the neighbouring 
springs of Borcette, or Burtscheid. This is a suburb of Aix, 
from which it is separated by the viaduct of the railway, and 
is a very quaint-looking old town, divided into an upper and 
lower quarter, consisting for the most part of dwellings of the 
poorer class, with the exception of eight or ten large bath- 
houses, a few hotels, and an ancient monastery of the ninth 
century, now the parish church, on the hill above the town. 
That we were in a place rich in thermal springs was evident 
the moment we entered Borcette, as through almost every 
street ran a river of hot mineral water. 

The mineral springs of Borcette are divided into sulphurous 
and saline. The sources in the upper quarter of the town 
are distinguished from the lower springs, as well as from 
those of Aachan, by not containing either sulphate of soda 
or sulphuretted hydrogen gas. Of the sulphurous waters 
of Borcette, the most important is the Trinkquelle. The tem- 
perature of this spring is 138°, and it contains 30 grains 
of saline ingredients to the pint, 20 grains of which is 
chloride of sodium, 2 grains sulphate of soda, and 6 grains 
of carbonate of soda. 

Amongst the non-sulphurous sources that most generally 
used is the Kochbrunnen, the temperature of which is 150°, 
and its chief saline constituents carbonate and sulphate of 
soda and chloride of sodium. 

The waters of Borcette, which are warmer than any of 
those of Aix, are employed internally and externally, and are 
prescribed in cutaneous diseases — in dyspepsia and hepatic 
complaints, and in calculous affections. Moreover, the local 
physicians say they are applicable in some cases of scrofula, 
gout, and rheumatism. They are annually resorted to by close 
on twelve thousand visitors, chiefly Germans and French, this 
place being a much cheaper residence than Aix-la-Chapelle. 



164 EMS. 



CHAPTER XXVIII. 



EMS. 



The route from Aix-la-Chapelle to the next spa on our list 
led us through Cologne and along the Rhine, as far as 
Oberlandstein, whence twenty minutes' journey by train 
brought us to Ems. This town which, with the exception of 
Carlsbad, is the most aristocratic watering-place in Europe, is 
situated on the right bank of the Lahn, and is divided into 
" Bad-Ems," the quarter around the springs, and " Dorf-Ems," 
the adjoining suburb. Bad-Ems consists of a row of houses 
built in crescent shape, between the river and the precipitous 
hills, which rise immediately behind it, and is connected with 
the railway station by a handsome bridge. Opposite to this 
is the chief drinking spring and the cursaal, forming the 
extremity of the new quarter, from which an avenue of hotels 
and lodging-houses, fully a mile long, extends to Dorf-Ems, or 
the old village. 

There are no less than twenty-five saline chalybeate springs 
here, of which, however, only three are used internally. 

The Ems waters are strongly alkaline, clear and sparkling, 
and vary in their temperature from 118° to 83°. In taste, the 
hotter sources, to some extent, have the peculiar "chicken 
broth flavour " of the Kochbrunnen of Wiesbaden, conjoined 
with a slightly chalybeate taste. 



EMS. 



165 



Composition of the jpr 


incipal Mineral Springs of Ems. 




Kesselbrunnen. 


Krah nchen. 


Furstenbrunnen. 


Temperature, 


116° 


90° 


96° 


Carbonic acid, 


16-4480 


26-8160 


15-6760 


Carbonate of soda, 


14-7418 


12-6108 


16-5526 


Carbonate of strontia, . 


trace. 


trace. 


trace. 


Carbonate of lime, 


1-4474 


1-4400 


1-5263 


Carbonate of magnesia, 


0-3200 


0-4975 


0-6206 


Carbonate of protoxide of iron 


0-0576 


0-0096 


0-0195 


Oxide of manganese, 


trace. 


trace. 


trace. 


Sulphate of soda, 


0-3538 


0-3981 


0-3678 


Chloride of sodium, 


7-0216 


6-3349 


5-8335 


Chloride of magnesia, . 


0-3318 


0-3758 


0-5248 



The springs of Ems, being alkaline, saline, and alterative, 
are principally suited for cases requiring a mild, anti-acid 
aperient, increasing the secretions and improving the appetite. 
They are applicable in some chronic uterine ailments, and 
nervous diseases arising from these causes in females. They 
are, moreover, strongly recommended in aphonia, hooping- 
cough, dyspepsia, and many other complaints. 

By some writers these waters have been advised in the 
treatment of chronic bronchitis, senile catarrh, the early stages 
of consumption, and "debility of the chest." As I do not 
understand the meaning of the latter term, I shall express no 
opinion on it. But with regard to the statement which 
appears in several books, English as well as foreign, on this 
subject, that cases of consumption may be benefited by the 
mineral springs of Ems, I must express my doubt that any 
case of phthisis is curable by any mineral water whatever. 



166 SCHWALBACH. 



CHAPTER XXIX. 

SCHWALBACH AND SCHLANGENBAD. 

From Wiesbaden, Schwalbach may be reached in a couple of 
hours by diligence, or by the Rhine steamers to Eltville, and 
thence by coach, in the same time. On my arrival at 
Schwalbach by the latter route, alighting at the JSTassauer 
Hoff, I proceeded to call on the principal physician of the 
town, to whom I had a letter of introduction. Before 
accompanying Dr Genth, however, through the springs and 
baths, a brief coup oVaiil over the town will not be misplaced. 

Langen-Schwalbach is said to have been the favourite 
watering-place of the Roman legions stationed in Gaul. But 
it was almost unknown by English valetudinarians until 
forty-five years ago, when Sir Erancis Head published his 
" Bubbles from the Brunnens," and such was the effect of his 
panegyric, that the hotels of Schwalbach are now crowded 
with English and American visitors during the season. 

The town itself contains between two and three thousand 
resident inhabitants, and is situated in a little valley sunk 
between the lofty hills which form the table-land of the 
Taunus range. The name " Langen " is well applied, for the 
entire place consists of a long straggling street, expanding 
near the centre into a \kind of open crescent, with two short 
diverging streets, the whole being built somewhat in the shape 
of a capital Y. 

In the way of amusements Schwalbach has not much to 



SCHWALBACH. 167 

boast of ; excellent bands play at stated hours in the Allee ; 
there is a pretty park and miniature lake, reading and billiard 
rooms in the village, and charming walks and drives in the 
vicinity, et voila tout. 

The principal mineral springs of Schwalbach are the 
" Weinbrunnen," the " Stahlbrunnen," and the " Paulinen- 
brunnen." 

The Weinbrunnen is agreeable, piquant, and ferruginous 
in taste. This source was first brought into vogue by Dr 
Theodore of Worms, who in 1581 extolled its use as a remedy 
for the unpleasant feelings experienced the morning after an 
extra cup of wine, and hence is derived its name. 

The Weinbrunnen is considerably stronger in iron than 
either the Stahl or Paulinenbrunnen, but containing less 
carbonic acid gas is less exciting, and agrees better with some 
constitutions than the other sources. 

The Stahlbrunnen, which is situated at the extremity of a 
shady promenade, — the Allee, — is very similar to the Wein- 
brunnen, but is still more gaseous. The temperature of the 
water is 50°, or 1° higher than the last spring. 

From the Stahlbrunnen a very pretty walk through the 
Allee, over which the foliage formed a complete arch the 
entire way, brought us to the Paulinenbrunnen, of which every 
reader of the " Bubbles from the Brunnen " will recollect Sir 
Francis Head's glowing description; but were Sir Francis 
now to revisit his favourite spring, he would hardly recognise 
in it his own picture. For ever since Dr Fenner's death, 
some years agD, the Paulinen has been declining in favour, and 
is now comparatively disused. Its temperature is 2° lowei 
than the Stahlbrunnen. Being the mildest of the springs, it 
agrees in some cases in which the stronger waters of the Wein 
or Stahlbrunnen would not be tolerated. 

In nearly all cases in which a ferruginous water is 



168 



SCHWALBACH. 



required, the springs of Schwalbach have been recommended, 
and there is no Continental chalybeate spa more resorted to 
by English invalids. 

In the following table I have nearly followed Dr Sigismund 
Sutro's analysis of the 

Composition of the Schwalbach Mineral Sources. 



Contents. 





Wein- 


Stahl- 


Paulinen- 


Rosen- 




brunnen. 


brunnen. 


brunnen. 


brunnen. 


iron, . 


0-83 


075 


0-65 


0-91 




211 


1-45 


2-95 


2-95 




3-12 


0-88 


2-75 


0-98 




0-17 


0-25 


0'45 


0-35 




0-18 


0-34 


0-03 


32 




0-16 


0-21 


0-02 






6-59 


3-83 


6-86 


5-51 




26 cub. in. 


28 cub. in. 


39ijcub.in. 


26 cub. in. 



Carbonate of protoxide of 

Carbonate of lime, . 
,, ,, magnesia, 
,, ,, soda, . 

Chloride of sodium, 

Sulphate of soda, 

Total solid contents, 
Carbonic acid gas, 



Three-fourths of the invalid visitors to Schwalbach suffer 
from some form of anaemia, amongst whom may be found a 
great many ladies labouring under chlorosis, or whose ailment 
is weakness and want of tone, following a London season, and 
for such patients the quiet of Schwalbach is perhaps not less 
useful than its chalybeate springs. In the debility following 
convalescence from severe and exhausting maladies, and in 
the weakness resulting from long-protracted nursing, the 
Paulinen or Weinbrunnen, sometimes even diluted, are often 
serviceable. Nearly all authorities on the subject speak of 
the powerful action of this spa in certain forms of functional 
derangement of the female system, and my own experience in 
several instances leads me to share this opinion. 

In chronic indigestion, consequent loss of flesh, and consti- 
pation, depending on a relaxed and torpid condition of the 
mucous membrane of the stomach and alimentary canal, 
which the drastic remedies, that many people take habitually, 
can only aggravate — a visit to Schwalbach may be prescribed. 



SCHLANGENBAD. 169 

These waters should be taken fasting, in doses of from half 
a glass to two small glasses twice a day, and should be 
followed by a brisk walk. Their use would prove highly 
dangerous in cases of hemorrhagic or organic disease of the 
lungs, heart, or kidneys. 

Schlangenbad lies six miles from Wiesbaden, midway be- 
tween Eltville and the spa I have just described, in a valley 
almost hidden amongst thickly-wooded hills. It can hardly 
be called even a village, for it consists merely of a few bath- 
houses, hotels, and some twenty or thirty large barrack-like 
lodging-houses, irregularly scattered through the little valley. 
Being situated on the south-western slope of the Taunus 
range, and well protected from harsh winds by the hills, it 
enjoys a more genial climate than Schwalbach. There is in 
Schlangenbad a kind of " Sleepy-Hollow " atmosphere, which, 
irksome and even injurious as it would prove to many, must, 
I am sure, be most useful in some cases of nervous irritability 
and excitement, resulting from extreme mental tension and 
over attention to any absorbing pursuit in busy civic life. 

Apart from this placid tranquillity, this dolce far niente 
existence, there is little or no attraction in Schlangenbad for 
any but real valetudinarians. For, beautiful as is the scenery, 
and interesting as are the excursions in its vicinity, they are 
almost equally accessible from Schwalbach or Wiesbaden. 

The waters of Schlangenbad belong to the same class of 
mineral springs as those of Pfeffers and Wildbad, being, 
however, stronger than either of these spas. They are mildly 
alkaline and thermal, and are chiefly employed for bathing 
purposes. There are eight distinct springs, which vary in 
temperature from 77° to 90°. They rise at the foot of the 
adjacent mountain, whence they are conducted to the bath- 
houses. They all contain about eight grains of solid ingredients, 
with two cubic inches of carbonic acid gas, and the same 



170 SCHLANGENBAD. 

amount of nitrogen in the pint. Of the solid constituents, 
about one-half consists of carbonate of soda, together with two 
grains of common salt, and one grain each of carbonate of lime 
and carbonate of magnesia. The special action of this spa 
seems to be on the skin, which it is said to render soft and 
white ; and, therefore, I need hardly add, is largely patronized 
by the fair sex. 

The power of diminishing nervous irritability has been 
ascribed to these waters by many writers, and they are, 
moreover, largely employed in the treatment of chronic 
rheumatism, as well as neuralgia and other nervous affections. 
In cutaneous diseases, too, such as lichen and prurigo, when a 
remedy is required to allay excessive irritation of the surface, 
a course of the Schlangenbad baths is often prescribed with 
advantage. Hufeland and other German writers recommend 
these baths in the articular rigidity of advancing years, as the 
veritable "Fountain of Youth" of the fairy tales. As a 
specimen of the rhapsodies which German spa physicians 
sometimes indulge in, I shall conclude this chapter with the 
following morceau from the late Dr Fenner of Schwalbach, 
who, in describing the effects of this bath, thus falls into an 
ecstasy of praise — " Vous sortez des eaux de Schlangenbad 
rejeuni comme un Phoenix — la jeunesse y devient plus belle, 
plus brillante, et Tage y trouve une nouvelle vigeur." 



WIESBADEN. 171 



CHAPTEE XXX. 



WIESBADEN. 



Wiesbaden enjoys a situation that renders it one of the 
most picturesque of the German spas, and which should also 
bless it with a climate superior to many of them, being built 
in an opening valley, extending from the southern slope of the 
Taunus Mountains to the Ehine, and thus completely pro- 
tected from the north and east winds. The first view of the 
town is certainly prepossessing: the streets are wide and 
clean ; the buildings are large, bright, and new looking ; and 
the square in front of the cursaal, and that edifice itself, are 
really handsome. Since I first visited Wiesbaden, however, 
it has lost much of the life and gaiety which formerly were 
the special characteristics of this place. The political changes 
by which, nearly ten years ago, it was converted from the 
flourishing capital of an independent state into a provincial 
watering-place, have probably more to do with the somewhat 
triste aspect of this once gayest of spas than the closure of 
the gambling tables, which has fortunately taken place more 
recently. 

The hot springs of Wiesbaden were resorted to by invalids 
at a very early, date. Pliny describes them, — "Sunt et 
Mattiaci in Germania fontes calidi trans-Ehenum, quorum 
haustus triduo fervet; circa marginem pumicem faciunt 



172 WIESBADEN. 

aqua,"* and the remains of numerous " Balnearia " have been 
discovered in the vicinity of the mineral sources. 

There are no less than twenty-two thermal springs in 
Wiesbaden. Some writers describe each of these separately, 
and assign different properties to each, but as all issue within 
an area of 3000 yards, and vary chiefly in temperature, in all 
probability they originate from the same source, and there- 
fore, in the following remarks, I have confined myself to the 
Kochbrunnen, which I regard as a type of the other 
springs. 

The Kochbrunnen rises nearly in the centre of the town. 
The appearance of the water is far from inviting, having a 
turbid yellowish colour, with a scum floating on the surface. 
The taste, however, is by no means unpleasant, and Sir 
Francis Head's comparison of it to " weak chicken broth " has 
been copied by every succeeding author as conveying an exact 
idea of its flavour. Its temperature is 155°, and the saline 
constituents in a pint of this water are 52 grains of common 
table salt, 4 grains of chloride of lime, 3 J grains of carbonate 
of lime, 1J grains of carbonate of magnesia, and rather more 
than a grain of chloride of potassium. Besides these, it con- 
tains sixteen other ingredients, but in such small proportions 
as to be of no practical importance. 

The thermal springs of Wiesbaden are principally employed 
for bathing ; but as the Kochbrunnen is also extensively used 
internally, a few observations on its effects when employed in 
this way are necessary. This source is daily frequented by a 
considerable number of invalids, most of whom seem to suffer 
from gout, or dyspepsia, or hepatic disease. 

Like all other mineral waters, this should be taken fasting, 
before breakfast. The dose varies from eighty to thirty ounces 
of the Kochbrunnen, which is sipped slowly, while the patients 

* Pliny, " Hist. Nat.," lib. xxxi. c. 17. 



WIESBADEN. 173 

promenade about the spring, and the exercise, I have little 
doubt, does almost as much good as the water. 

The action of Wiesbaden mineral water is mildly purgative 
and diuretic. The circulation is always more or less excited 
by it, the biliary secretion is augmented, the action of the 
absorbents is quickened, and the appetite is sharpened, though 
this should not be indulged. If the Kochbrunnen be now 
persisted in for some weeks, the bulk of the body diminishes 
visibly, the expanded abdomen subsides, obesity disappears 
and the outlines of muscles, previously concealed by super- 
abundant fat, are thus brought into view. 

After some time the blood generally becomes thinner and 
less rich in fibrinous compounds, respiration is now freer, the 
skin becomes clear and healthy-looking, and the valetudinarian 
experiences a general feeling of hien etre. 

Such are the effects of the Kochbrunnen when it agrees 
with the patient. Unfortunately, however, it does not answer 
every case, though some of its panegyrists seem to think it 
does, being especially contra-indicated in cases of organic 
visceral and hemorrhagic disease. When the course is 
prolonged beyond six or seven weeks, symptoms of febrile 
disturbance, or " saturation fever," are produced. 

The diseases in which the internal use of the Wiesbaden 
springs are recommended are gout, dyspepsia, and plethora. 
In the irregular and atonic forms of gout, the saline waters 
of Wiesbaden often produce great benefit. Eepeated experi- 
ments have shown that the amount of urea and uric acid 
eliminated by the kidneys is greatly increased under their use, 
and at the same time the patient's general health is improved 
by the alterative action of the spa. In some cases of lurking 
gout, this water brings on a fit of regular podagra, which is 
generally attended with complete relief of the other symptoms. 

I have already mentioned that the warm springs of 



174 WIESBADEN. 

Wiesbaden are principally used for bathing purposes, and the 
number of baths in the town is something extraordinary, 
amounting to nearly nine hundred. Almost every hotel has 
its thermal department, supplied from the twenty-five sources 
I have spoken of. 

The bath should either be taken in the morning, fasting, or 
in the evening five or six hours after an early dinner. The 
patient at first should not remain more than ten minutes in 
the water, but may gradually, if so advised, increase this 
period to an hour. 

The great majority of those who resort to Wiesbaden suffer 
from rheumatism, or from that combination of gout and 
rheumatism permanently affecting the joints which is known 
as chronic rheumatic-arthritis. Of one hundred and twenty- 
nine cases of chronic rheumatism treated by Dr Haas, in the 
hospital of Wiesbaden, by spa water, above thirty were com- 
pletely cured, and seventy-nins were improved. The German 
physicians also recommend these baths as a remedy in rheumatic 
paralysis, where the power of voluntary motion is lost, and 
parts are forced into unnatural constrained positions, by long- 
continued arthritic inflammation. 



HOMBURG. 175 



CHAPTEE XXXI. 

HOMBURG, NAUHEIM, NEUENAHR, AND KREUZNACH. 

Three-quarters of an hour's drive" by the northern railway 
brought us from Frankfort to one of the most frequented spas 
of Europe, Homburg-on-the-hill, which is situated on one of 
the lowest slopes of the Taunus range, immediately under the 
Great Eeldberg peak. Of the three parallel avenues descend- 
ing from the hill, of which, together with a couple of cross 
passages intersecting them, the town of Homburg consists, 
only one, the Luisen Strasse, deserves the name of a street. 
The upper part of this thoroughfare, with a few narrow lanes, 
forms the old town round the castle; while the lower part, 
which is entirely modern, contains the railway station, 
cursaal, and hotels, forming the new town. 
. The Kursaal occupies a prominent position in the main 
street, and is regarded by the inhabitants as the great feature 
of their town, being spoken of by them with that affectionate 
pride with which an Andalusian speaks of the Alhambra of 
Granada, or the mosque of Cordova, and in truth was, until a 
few years ago, one of the most elegant dens of iniquity in 
Germany, as well as the main support of that exalted 
potentate, the late and last landgrave of Hesse-Homburg. 

The mineral springs of Homburg issue from a thick vein of 
quartz, covered by a stratum of gravel and clay, lying a hundred 
and fifty feet below the surface. These sources are all saline, their 



176 HOMBUKG. 

principal ingredient being common table salt, or chloride of 
sodium, in addition to which they contain a small proportion 
of iron. They also contain a large amount of free carbonic 
acid gas. All the springs, however much they may differ in 
strength, and even in composition, rise in close proximity to 
each other in the Kurgarten, a beautifully-kept park, con- 
nected with the cursaal, and occupying a small valley on the 
south-east side of the town. 

The principal mineral spring is the Elisabethquelle, which 
was originally one of the sources of an abandoned brine manu- 
factory, and had been disused for upwards of a century, until 
its medicinal properties were discovered in 1834. According 
to the late Baron Liebeg's analysis, each pint of this water 
contains 79 grains of common salt, 10 grains of carbonate of 
lime, 7 grains each of chlorides of magnesia and lime, 2 grains 
of carbonate of magnesia, half a grain of carbonate of iron, and 
traces of several other salts, which it would be useless for 
practical purposes to enumerate here. The quantity of 
carbonic acid gas the Elisabethquelle contains is its most 
remarkable characteristic, there being rather more than 48 
cubic inches of gas in a pint of the water. 

The Stahlbrunnen, which lies nearer to the cursaal, is an 
artesian well, and was opened about twenty-five years ago. 
The chemical composition of this spring is very similar to 
that of the Elisabethquelle, but it is not quite so rich in 
carbonic acid gas, and, as the name implies, contains some- 
what more iron, amounting to nearly a grain to the pint. 

The Kaiserbrunnen is also an artesian well containing a 
very large volume of carbonic acid gas, which gives rise once 
in every ninety seconds to a peculiar bubbling and ascent of 
the spring in the basin, like water on a quick fire. This is 
evidently caused by the subaqueous accumulation and subse- 
quent escape of gas. In each pint of this spa are dissolved 



HOMBUEG. 177 

117 grains of common salt, 13 grains of chloride of lime, 
7 grains of chloride of magnesia, half a grain of carbonate of 
protoxide of iron, and a quarter of a grain of muriate of potash. 

The next source is the Ludwigsbrunnen, which was the 
oldest used, and is the weakest of the Homburg springs. 

The dose of Homburg water varies from six to forty-eight 
ounces, and must depend, in each particular case, upon the 
patient's age, sex, constitution, and ailment, as well as on the 
spring he may be advised to use ; the Kaiserbrunnen, for 
instance, being double the strength of any of the others. In 
general, however, small draughts of from four to eight ounces, 
repeated at short intervals, are more advisable than a larger 
quantity at one dose. 

All the mineral sources of Homburg belong to the class 
of ferro-saline waters ; of which Kissingen, in Bavaria, and 
Cheltenham, in England, are examples, though of very 
different degrees of strength. In the treatment of gouty 
dyspepsia and hypochondriasis, attended with derangement of 
the liver, torpid or irregular intestinal action, and depression 
of spirits, a course of Homburg water often affords the best 
remedy. It is also used in cases of general plethora, and in 
what the German spa physicians term " abdominal plethora," 
an affection to which they attach considerable importance, 
and, so far as the cathartic properties of the water go, I have 
no doubt that it is very properly employed in such cases, 
especially as the "spa doctors," moreover, enjoin a regimen, 
which, of itself, would probably effect the cure. 

The chloride of lime, contained by all these waters, in- 
creases the action of the absorbents and glandular system, 
and probably accounts for the benefits which have been 
occasionally observed to follow the use of this spa, in cases 
of scrofulous disease. 

In varicose veins and ulcers the Homburg waters are said 

M 



178 HOMBURG AND NAUHEIM. 

to be productive of some advantage, by diminishing the 
tension of the diseased vessels, to which their chalybeate 
qualities impart a healthier tone. 

In hysterical affections and amenorrhoea, this spa is fre- 
quently serviceable by restoring normal menstruation. In 
such cases it often proves the superiority of natural to 
artificial preparations, by the well-marked chalybeate action, 
which so small an amount of iron as that contained in these 
springs, the strongest of which holds only one grain of iron 
in a pint, is capable of exercising. 

The usual duration of " the course " at Homburg is about 
three weeks, and I need not repeat the caution given in 
the introductory chapter against the use of these or any 
other mineral waters when symptoms of " saturation " have 
shown themselves, nor dwell on their possible dangers in 
organic and heemorrhagic diseases. In combination with their 
internal use, the Homburg springs are sometimes employed 
for bathing, and the large amount of saline matter they con- 
tain renders these baths highly stimulating to the cutaneous 
capillaries. Their application in this way, however, is neither 
extensive nor generally advisable. 

Nauheim is within an easy drive of Homburg, and is 
situated on the declivity of the Johaninsberg hill, on the 
railway from Frankfort to Cassel, and about an hour's journey 
from the latter place. The town is new and unfinished- 
looking, and contains a population of about 2000 inhabitants. 

These waters have long been employed in the manufacture 
of salt, but only within the last few years have been resorted 
to medicinally. There were formerly a vast number of 
natural saline springs here, but their sources were gradually 
interfered with by the sinking of artesian wells, of which there 
are six or seven. The principal of these is the "Grosser- 
Sprudel," which burst from an unfinished artesian well, in 



NAUHEIM AND NEUENAHR. 179 

the night of December the twenty-first, 1846, in a thick 
column of water to a height of nearly eighteen feet from the 
surface, and thus it has continued to issue ever since. It is 
enclosed within a large open stone basin, the water in which, 
from the vast quantity of carbonic acid gas it contains, is 
white with foam. It contains, besides, two hundred and 
fifteen grains of saline matter to the pint ; of this one 
hundred and eighty-one grains are common salt, together with 
fourteen grains of chloride of calcium, eleven grains of car- 
bonate of lime, four grains of chloride of potassium, with other 
salts, and a trace of bromine. Its temperature is about 90°. 
This source is strongly purgative in doses of one glass, but is 
principally used for bathing. 

The Kurbrunnen and Salzbrunnen rise near each other. 
The former is that usually employed internally; it is the 
weakest of all the Nauheim springs, containing one hundred 
and thirty-three grains of salt to the pint ; in the chemical 
composition of its ingredients it, however, resembles the 
Grosser-Sprudel, as also does the Salzbrunnen, which contains 
one hundred and sixty-nine grains, and the Kleiner-Sprudel, 
containing one hundred and eighty-one grains, in the same 
quantity of water. 

The effect of these springs used internally is purgative and 
diuretic. Their principal use is, however, for baths in cases 
requiring a stimulating application to the skin, in obstinate 
and languid cutaneous complaints. They are said to exercise 
a specific action in accelerating and increasing the catamenia. 
They are also prescribed in certain cases of chronic rheumatism, 
in scrofulous tumours, and diseases of bone. 

On the opposite bank of the Ehine to any of the German 
watering-places just described are two spas, both of which 
have of late years become of considerable importance; the 
first of these is ISTeuenahr, which may be reached by railway 



180 NEUENAHR. 

from Cologne in an hour and a half, or still better by the Ehine 
Company's steamers to Keniagen, from which a very pretty 
drive of barely seven miles along the valley of the Ahr brings 
us to Neuenahr. Midway on the road the spa tourist may 
stay for a moment at Ahrweiler to visit the source whence 
the Apollinaris water, so familiar on every table as a sub- 
stitute for Seltzer water, is exported. 

Neuenahr, which was first brought into notice in this 
country by the late Professor Miller of Edinburgh, belongs to 
the class of saline alkaline spas, and now attracts a consider- 
able number of English and American gouty and dyspeptic 
valetudinarians. The place itself contains half a dozen good 
hotels, and the usual resources of a small German watering- 
place, and needs no further description. 

The chief saline ingredients of the Neuenahr springs are 
the bicarbonates of soda, magnesia, and lime, with a small 
amount of sulphate of soda, and a trace of protoxide of iron 
dissolved in a highly carbonated thermal water, the tempera- 
ture of which is about 130°. It will be thus seen that this 
spa belongs to the same class as Vichy or Fachingen. 

The Neuenahr springs are used internally in doses of from 
two to four small glassfuls twice in the day. The baths, 
however, and more especially the douche baths, the system of 
which is very perfect here, are the main attraction of this 
place for rheumatic and gouty patients, by whom, as well as 
by those suffering from chronic hepatic disease, dyspepsia, 
and some sub-acute, renal, and non-inflammatory uterine 
disorders, this spa is chiefly employed. The baths are also 
largely prescribed in chronic skin diseases, especially eczema 
and prurigo. 

Nearly opposite to Schlangenbad, and about the same 
distance from the Ehine, is Kreuznach, which is within less 
than half an hour's journey by railway from Bingen. This 



KREUZNACH. 181 

town, which contains a population of some 12,000 inhabitants, 
is prettily situated in the valley of the Nahe, and though long 
celebrated for its saline wells and salt-work, has only com- 
paratively recently come into note as a watering-place, and 
is now one of the most important iodated-bromated spas in 
Europe. 

The principal saline springs of Kreuznach are the Elisen- 
quelle, which is the only source used internally, the Oranien- 
quelle and the Nahequelle, which are used for baths, and 
locally in the form of concentrated brine or mutterlange. The 
Elisenquelle contains ninety-four grains of saline matter in 
each pint, and of this no less than seventy-two grains 
consist of common table salt, thirteen grains of chloride of 
lime, four grains of chloride of magnesia, and one and a 
half grains of carbonate of lime, the balance of the solid 
ingredients dissolved in this quantity of the water being made 
up of minute quantities of bromides and iodides of soda and 
magnesia, carbonates of baryta, and protoxides of magnesia 
and iron. 

The " mutterlange," which is used as an addition to the 
ordinary baths as well as for local applications, is merely a 
concentrated solution of the salts just mentioned, and is 
obtained on a large scale as the residuum of the process by 
which table-salt is here manufactured. 

This "mutterlange," one pint of which contains 1642 grains 
of the salts above named, is a thick, yellowish, oleaginous- 
looking fluid, intensely bitter in taste, and having a slightly 
iodated odour. The internal use of the water is generally 
conjoined with a course -of the Kreuznach baths, and is ad- 
ministered in doses of from four to eight ounces twice daily. 
The duration of the baths varies from fifteen to forty-five 
minutes; and at first the pure mineral water is employed, 
but afterwards the " mutterlange " is usually added in increas- 



182 KEEUZNACH. 

ing quantities, commencing with a quart and gradually 
reaching to ten or twelve quarts of the concentrated brine to 
each bath. The usual duration of the course, if not inter- 
rupted by saturation fever or otherwise, is one month. 

The Kreuznach waters and baths may be employed in the 
treatment of every form of scrofulous disease, rickets, chronic, 
glandular, and arthric enlargements, chronic inflammation or 
congestion of the uterus and ovaries, the most frequent cause 
of the anomalous chronic diseases of women, and more 
especially of sterility, in cases of which I have repeatedly 
prescribed the Kreuznach waters with remarkable effect. In 
mammary enlargements, and especially in tumours causing 
apprehension of cancer of the breast, I have seen the most 
satisfactory results from a course of these baths, and the local 
application of compresses soaked in the " mutterlange." 



WEILBACH AND SODEN. 183 



CHAPTEE XXXII. 



WEILBACH AND SODEN. 



From Wiesbaden an hour's drive by train, through a richly- 
cultivated vine-country, and affording en passant a glimpse of 
the spires of Mayence, brought us to the little village of 
Florsheim, where we alighted at 9 A.M. of a bright sunny 
morning. Hence, half an hour's drive through a continuous 
orchard conducted us to the baths of Weilbach, which are 
situated on a slightly rising ground, in the valley of the 
Maine, midway between Mayence and Frankfort, and about 
two miles from the river. There is nothing in the shape of a 
town or even village at Weilbach, which merely consists of 
the bathing establishment. 

The mineral source rises in the garden of this building, 
and is very., clear, of a slightly saline, alkaline, feebly 
sulphurous taste, but is not disagreeable, and has a tempera- 
ture of 55°. The sides of the basin are thickly coated by a 
soft, whitish, soapy deposit, which consists of carbonate of 
lime, sulphur, and a peculiar organic matter. The water, 
though not sparkling, contains six cubic inches of carbonic 
acid, and three inches of sulphurated hydrogen gases in the 
pint. According to the most recent analysis the same quan- 
tity of water contains four and a half grains of carbonate of 
soda, two and a half grains of carbonate of lime, two grains 
of carbonate of magnesia, two grains of common salt, one 



184 WEILBACH AND SODEN. 

grain of chloride of magnesia, a little sulphate of^ soda, and 
some other ingredients, amounting in all to twelve and a half 
grains. 

Used in full doses this spring is mildly aperient; in smaller 
quantities it is said to stimulate the appetite, and also to pro- 
mote the removal of chronic visceral enlargements and 
congestions, especially of the liver. Most German physicians 
seem to be possessed by an extraordinary hallucination that 
all obscure diseases or complaints, the causes of which are 
not obvious to them (and I need hardly observe that the 
number is not limited), are produced by suppressed haemor- 
rhoids ; and it is further asserted by the local writers that 
the Weilbach springs are a panacea for these ailments. A 
large number of the invalids who visit this spa suffer from 
thoracic affections, and we are told that incipient consumption, 
chronic cough, and spitting of blood, are among the cases 
which come within the range of this remedy. I do not wish 
to express discredit of any particular writer ; but I have no 
hesitation whatever in saying, as the result of very consider- 
able experience of phthisis in^ various parts of the world, that 
I cannot believe that any consumptive patient was ever cured 
by the waters of Weilbach. 

The next spa in my itinerary was Soden, and thither I 
proceeded from Florsheim by the Taunus railway, passing 
through luxuriant orchards, where the proprietors, gathering 
in the easy harvest, seemed to be keeping a holiday rather 
than engaged in the toil of husbandry. 

Soden lies at the foot of the southern declivity of the Middle 
Taunus, below Konigstein, and only twenty-five minutes' drive 
by rail from Frankfort. The village — the old part of which 
is built in a little valley between the hills — is protected from 
the north and east winds by the Taunus range. 

The hotels are numerous and tolerably good. The soil is 



SODEN. 185 

peaty, and, as the only water found here is saline and mineral, 
the potable water is conducted from the neighbouring moun- 
tains. The saline sources issue from slaty rocks, and rise 
within a short distance of each other to the number of 
twenty-three. 

The Soden springs are saline, acidulous, and ferruginous. 
In taste they are more or less piquant and saline, according to 
the amount of carbonic acid gas and chloride of soda which 
the sources all contain in different proportions : from twenty- 
four grains, which is the minimum in the " Milchbrunnen," to 
a hundred and twenty grains, wmich is the maximum in the 
" Salzquelle." The latter also contains the largest amount of 
iron and carbonate of lime. 

The action of the Soden water is stimulant, diuretic, 
mildly aperient, and alterative. The resident physicians tell 
us that "the appetite invariably improves under the use of 
the water, — and this spa appears to be particularly well 
adapted to the treatment of atonic dyspepsia and languid 
digestion. The functions of the liver are excited by its use, 
and the biliary secretion is increased and becomes more 
healthy, therefore its use is indicated whenever this organ 
acts torpidly." 

The Soden spa is also recommended in chronic mucous 
catarrh. This water moreover determines powerfully to the 
skin, and is used with great benefit in some obstinate chronic 
skin diseases, in scrofulous enlargement of the glands, and 
in chronic rheumatism. 



186 KISSINGEN. 



CHAPTEE XXXIII. 

KISSINGEN, BOOKLET, AND BKTJCKENAU. 

From Frankfort the journey by railway via Wiirzburg and 
Schweinf urt to Kissingen now occupies rather less than six 
hours. Kissingen, in the Bavarian department of the Lower 
Maine, is situated on the Eiver Saale, in the centre of a wide 
valley surrounded by thickly- wooded hills. The town itself 
is a mere watering-place, composed almost entirely of large, 
newly-built hotels and lodging-houses, which during the 
season generally accommodate about five thousand visitors. 

The three principal springs rise close to each other in the 
" Kurgarten," a kind of small park, a little to the south of the 
town. The one we examined first was the Maxbrunnen 
spring, which rises from the sandstone rock with a loud hissing 
sound, and bright and sparkling, containing thirty-one cubic 
inches of carbonic acid gas in each pint of the water. The 
Pandur source is next to this, and is chiefly employed for 
baths, but may be drank in many cases in which the Eagoczy 
is too powerful. Like that spring, its action is aperient and 
solvent, and also increases the cutaneous and renal secretions. 

A few yards to the right of the last-described spring is 
situated the most celebrated of these sources, and that which 
is generally understood when " Kissingen Water " is spoken 
of, namely, the Eagoczy, or Eakoczy. This spring was dis- 
covered in 1738, in the old bed of the river, which was then 



KISSINGEN. 187 

turned into its present channel. Its taste is extremely 
unpleasant, being saline, bitter, acidulous, and somewhat 
chalybeate or astringent. 

About a mile from the other springs, to the north of the 
town, rises the Soolsprudel, which intermits, or ebbs and 
flows, with great regularity, eight or nine times daily. If we 
arrive a little before the " flow," on looking down the shaft 
through the thick glass cap, we see the well apparently 
empty; we then hear a distant rumbling noise, which 
gradually becomes louder and draws nearer, till in about 
half an hour from the time it was first heard, the water 
is seen foaming below ; it gradually ascends, and in another 
quarter of an hour reaches within a few inches of the top of 
the well, covered with white foam, and hissing and seething 
with great turbulence. Above the water hangs a heavy layer 
of carbonic acid gas, rising and falling with it. This gas is 
collected and ingeniously utilised in various forms of gas 
baths. The Soolsbrunnen acts as a powerful stimulant to 
the skin, and is principally used for bathing in the treat- 
ment of rheumatic, neuralgic, and cutaneous affections, and 
in scrofulous cases. The mother-lye, or concentrated brine 
of the Soolsprudel, is applied locally with great benefit in 
scrofulous and other glandular enlargements. 

The Kissingen springs are used in almost every variety of 
dyspepsia. The spa physicians assert that they are the best 
remedy for chronic or habitual constipation, and they cer- 
tainly act as very brisk and active cathartics, leaving no 
subsequent debility after their operation. Hypochondriasis, 
so intimately connected • with irregular gastric or intestinal 
action, is said to be peculiarly under the influence of the 
curative action of these waters; and judging from the physiog- 
nomy of the visitors, half the invalids who drink the Ragoczy 
seem to labour under that malady. 



188 



KISSINGEN. 



Composition of Kissingen Mineral Springs. 


**. 




Ragoczy. 


Pandur. 


Max- 
brunnen. 


Theresen- 
brunnen. 


Sool 
sprudel. 


Carbonic acid (cubic inch) . 


26-25 


28-85 


31-04 


28-35 


30-57 


Chloride of sodium, . 


65-05 


57-00 


18-27 


18-40 


107-51 


Chloride of potassium, 


0-91 


0-25 


1-00 


0-85 


0-97 


Chloride of calcium, 


... 








3-99 


Chloride of magnesia, 


6-85 


5*85 


3-10 


2 ; 75 


24-51 


Carbonate of soda, 


0-82 


0-03 


0-38 


0-39 




Carbonate of lime, 


3-55 


5-85 


2-59 


2-00 


l-*65 


Carbonate of magnesia, 


2-50 


1-62 


1-82 


3-37 


6-41 


Carbonate of iron, 


0-68 


0-45 






0-35 


Bromide of sodium, . 








0-07 




Bromide of magnesia, 


0-70 


0-68 






0-06 


Sulphate of soda, 


2-00 


1-75 


i' ; 86 


1-35 


25-30 


Sulphate of lime, 


2-50 


0-75 


0-65 


0-75 




Phosphate of soda, . 


0-17 


0-05 


0-12 






Silica, .... 


2-25 


1-55 


0-46 


0-50 




Oxide of aluminium, 


0-18 


0-05 








Organic extract, 


0-15 


0-09 






; 86 


Loss, .... 
Total solid contents in ) 


0-38 


0-37 


0-38 






85-74 


76-39 


30-65 


29-63 


187-68 


16 ounces, . ) 













In chronic enlargements and passive congestions of the 
liver and spleen the Kagoczy is often used with great advan- 
tage, but must be persevered in for some time after the patient, 
having gone through the ordinary course at Kissingen, has 
returned home. 

In cutaneous affections, when connected with gastric 
derangement, these springs are u considered to act as specifics. 
I know of hardly any mineral water which is not said to 
possess the property of curing sterility, and perhaps there is 
no place which has attracted so much attention on this 
account as Kissingen ; and in cases where barrenness results 
from chronic ovarian, or uterine inflammation or congestion, 
I believe that the Kissingen waters may in many instances 
be prescribed with advantage. 

A course of the Maxbrunnen is frequently conjoined with 
the use of the Pandur baths in the treatment of scrofulous 



cases. 



It is even asserted that the inhabitants of Kissingen 



BPOJCKENAU AND BOOKLET. 189 

who use the Maxbrunnen diathetically are therefore peculiarly 
exempt from strumous diseases. 

From Kissingen a picturesque mountain drive of about 
fifteen miles leads the spa tourist to the important watering- 
place of Bruckenau, which lies in the beautiful wooded valley 
of the Sinn. The springs are between two and three miles 
from the town, and around them are situated the baths, 
hotels, and lodging-houses, the royal palace, and Kurhaus. 
Two of the springs are on the left bank of the river, and 
contain only a small quantity of the salts of soda. One of 
these, the Sinnbergerquelle, is said to possess diaphoretic pro- 
perties, and is also prescribed in chronic bronchitis, scrofula, 
and calculous affections. On the opposite bank of the river 
is the Bruckenauquelle, from which this place derives its 
reputation as a chalybeate spa. It rises under a pavilion, and 
flows into a basin incrusted with protoxide of iron. The taste 
of the water is strongly ferruginous, although it only contains 
a quarter of a grain of iron to the pint. But this is rendered 
most active by the immense quantity of carbonic acid gas, 
near thirty-eight cubic inches of which is combined with it. 

The medicinal effect of Briickenau spa is tonic, and very 
stimulant. Its use is, therefore, dangerous whenever any 
disease, in which a powerful excitant would be improper, 
is present. It is, however, a very valuable stimulating 
chalybeate in certain cases, which I have already pointed out 
in the introduction, and need not repeat here. 

Nearly five miles from Kissingen is the chalybeate spa of 
Booklet, a little village of lodging-houses grouped around a 
magnificent central " Kur-Haus," or bath-house. There are 
here several mineral springs, which are used internally and 
for bathing. All the sources are cold, chalybeate, and very 
gaseous. These waters contain about two-thirds of a grain of 
iron, together with twenty-seven grains of chloride of sodium, 



190 BOOKLET. 

seven grains each of carbonate of lime and sulphate of soda, 
and other salts, amounting in all to nearly forty grains of 
saline matter to the pint. Their most important constituent, 
however, is carbonic acid gas, of which they contain thirty 
cubic inches to the pint ; and it is this gas which confers its 
peculiar activity on the iron dissolved in the spa. As may be 
supposed from its composition, the Booklet water is a very 
powerful stimulating saline chalybeate, and is peculiarly 
adapted to cases in which weakness of the digestive system 
is a prominent symptom. 



CARLSBAD. 191 



CHAPTEE XXXIY. 

CARLSBAD. 

Carlsbad may be reached in a little more than two days 
from London, the most direct line of railway being that via 
Calais, Frankfort, Hoff, and Eger, when a short run of two 
hours by a branch line brings us into the most beautifully 
situated watering-place in Germany. It lies at the bottom of 
a deep ravine, intersected by the Tepel, and surrounded by 
lofty hills, wooded to their summits. 

The resident population of Carlsbad does not probably 
exceed 4000 inhabitants, and the place may be described as 
consisting of a couple of streets called " Wiese," built along 
each side of the Tepel, and connected by eight or ten narrow 
bridges. 

Most of the hotels frequented by foreigners, some three or 
four of which are excellent and not exorbitant in their charges, 
are situated on the right bank of the river, on which is also 
the Sprudel. The great majority of the invalid visitors to 
Carlsbad, however, take up their quarters during their course 
of the waters in some of the large lodging-houses on the JSTeue 
Wiese, or in the Muhlbad Strasse, where excellent apartments 
for a family may be had for from twenty to thirty florins a 
week, but must be engaged for at least a fortnight. Behind 
these a number of steep streets ascend the hill, and farther on 
is a theatre and assembly rooms. 



192 CARLSBAD. 

On the opposite bank is the Alte Wiese, a long range of 
small shops, extending southward along the Tepel. Behind 
this is the Hirschen-Spriing, whence, as the tradition asserts, 
a stag, hunted by Charles IV., sprang across the river and fell 
into the Sprudel, which is about half a mile distant, and by 
its piteous cries in the boiling water, attracted the emperor's 
attention, who, coming up, despatched the deer, and then 
refreshed himself with a warm bath, which had the effect of 
curing a bad leg, from which he suffered. This event was 
commemorated by order of the grateful monarch, by the 
name Carlsbad (or Charles's .bath) being then affixed to the 
watering-place that at once sprang up around the emperor's 
bath. 

The altitude renders the climate of Carlsbad remarkably 
changeable, and even in summer the morning air is often 
bitterly cold, especially when the north or east winds, to 
which this valley is exposed, predominate. 

The town is built immediately over a vast subterranean 
boiler, covered in by deposits of the salts contained in the 
water, which evaporating has left them behind, and on the 
roof, or crust, thus formed, the town stands. The extent of 
this abyss or cavern of boiling water is quite unknown, as 
all attempts to fathom its depth have failed hitherto, The 
crust, however, that intervenes between the town and this 
cauldron is nowhere thicker than three feet, and in some places 
appears to be hardly as many inches. It therefore, I think, 
requires no great sagacity to predict, that in the event of any 
earthquake, the inhabitants of Carlsbad may probably try a 
longer bath in the Sprudel than any of its physicians would 
prescribe. 

Carlsbad is too remote, dull, and expensive, to attract, like 
the rival spas of the Ehine, any but real invalids and their 
attendants. 



CARLSBAD. 193 

The first morning I went out early to visit the springs I 
was surprised to see the crowd of people in the usually 
deserted-looking streets which lead to the wells. Every man, 
woman, and child carried a large beaker of steaming water in 
their hand, and were all gravely engaged in sucking the warm 
fluid through a small glass tube. Although this may be 
a very pleasant method of imbibing an iced sherry-cobbler on 
a hot summer's day, it certainly did not strike me as an agree- 
able mode of swallowing a large tumblerful of tepid Glauber 
salts and water at six o'clock on a damp autumn morning. 

There are no less than nine thermal springs in Carlsbad 
which are used medicinally.. These springs all rise from 
the same source, yet they differ materially in taste and 
temperature, according to the distance at which they issue 
from their common origin, and the nature of the strata they 
subsequently percolate. According to, Mr H. Gottl's analysis, 
the following table shows the 

Composition of the Sprudel. 



Contents of one Pint of Water. 


Grains. 


Sulphate of soda, 


14-9606 


Sulphate of potash, 


9-3696 


Chloride of sodium, 


8-7245 


Carbonate of lime, 


2-0198 


Carbonate of magnesia, 


03994 


Carbonate of protoxide of iron, 


0-0307 


Aluminia, .... 


0-2150 


Silica, ..... 


0-0520 


Total solid ingredients, 


44*8340 


Gaseous contents in Cubic Inches. 




Carbonic acid, . 


7-80337* 


Nitrogen, .... 


0-03181 



The great spring to which Carlsbad owes its fame, as a 
watering-place, is the Sprudel, which is situated almost 

* Dr Mannl calculates that 15,944 cwt. of Glauber salt, 13,000 cwt. of car- 
bonate of soda, 10,000 cwt. of common salt, and 2500 cwt. of carbonate of 
lime are annually discharged into the river from the Sprudel, and totally lost. 

N 



104: CARLSBAD. 

exactly in the centre of the town, on the bank of the river. 
The water issues under a kind of open turret, through which 
the constantly-ascending cloud of steam that escapes is visible 
for miles around. Under this a large iron fountain is placed, 
from which the Sprudel issues in remarkable jets, resembling 
on a vast scale those that escape from a divided arterial 
trunk, but intermitting their pulsations, however, and varying 
in volume and height from eight inches to as many feet, the 
average height of the jets being about three or four feet. The 
metal basins are thickly incmsted with the white calcareous 
incrustations of " Sprudel-stone " deposited by the water, 
which issues at the temperature of 170°. 

The other sources, which only differ from the Sprudel in 
their temperature, are the Hygieas-Quelle, temperature 165°; 
the Muhlbrunnen, 142° ; the Marketbrunnen, 135°; the Ber- 
nardsbrunnen, 154°; the Schlossbrunnen, 129°; the Felsen- 
quelle, 129°; and the Theresienbrunnen, 130°. 

The Theresienbrunnen is now the most resorted to of the 
Carlsbad springs, and is said to be more aperient though less 
exciting than the Sprudel. This source is especially in vogue 
with the gentler sex. When I first visited it at half-past six 
o'clock in the morning the fair valetudinarians were walking 
up and down in great numbers, sipping beakers of this fluid 
to the accompaniment of a tolerably good band. A number 
of white-coated Austrian officers, who were most unremitting 
in their attentions to the ladies, most of whom were, however, 
of a certain age, together with a few Eussians, some long- 
haired Saxon students, and a couple of dozen Israelites, from 
Frankfort, made up the assembly. I should not omit to add 
that one corner of the promenade was, by common consent, 
left free to a gentleman in black, with a thick moustache, who, 
held brief colloquies in turn with most of the people present, 
and was evidently a brother professor of the healing art. 



CARLSBAD. 195 

Of the long list of doctors who have extolled the efficacy of 

these waters, and their own skill, since Dr Payer of Elbogen 

first chronicled their virtues in 1522, none have achieved 

such celebrity as the Bohemian poet Lobkowitz, whose elegant 

Latin ode to the Sprudel has been translated into almost 

every European language. Lord Alvanley and the late Dr 

James Johnston have both rendered this ode into English; 

and a few lines from the latter version will suffice to show 

the spirit of the original, — 

" Sacred Font ! flow on for ever, 
Health on mankind still bestow ; 
If a virgin woo thee — give her 
Rosy cheeks and beauty's glow. 
If an old man — make him stronger ; 
Suffering mortals soothe and save, 
Happier send them home, and younger, 
All who quaff thy fervid wave !" 

Like most other mineral waters, Carlsbad has been extolled 
as the panacea for almost every disease in the interminable 
"catalogue of human infirmities. We might indeed send the 
majority of our clients there, if the result could be ensured 
which Dr Porges tells us occurred to one of his patients, 
"who got a most flourishing look; nay, even his mental 
faculties were highly raised in consequence of this full 
recovery." * 

The pathological effect that may be produced by the 
Carlsbad water is sufficiently important to demand some 
notice. A tendency to hemorrhagic and congestive affections 
and vertigo has been frequently observed here among patients, 
and ascribed to the mineral water : hence it is hardly neces- 
sary to add that it is contraindicated in all organic cerebral, 
pulmonary, or cardiac diseases. 

The special therapeutic action of Carlsbad water is in the 

* " The Mineral "Waters of Carlsbad, from a Homoeopathic point of Yiew," 
by Dr G-. Porges, p. 137, Prague, 1874. 



196 CARLSBAD. 

treatment of hepatic diseases. In enlargements, passive 
congestion, torpidity, and other chronic diseases of the 
liver, a course of the Sprudel is in many instances the 
most useful remedy that can be prescribed. In some forms 
of jaundice the rapidity of its action is remarkable, and its 
power of dissolving and eliminating biliary calculi is not 
less so. There is no spa so applicable in the majority of 
cases of hypochondriasis as this, the curative effects of which 
are explained by its purgative properties and its special action 
on the liver in such cases. 

The Carlsbad springs are beneficial in all affections depen- 
dent on an obstructed or torpid condition of. the abdominal 
viscera. They are, therefore, especially useful to valetudin- 
arians of an obese habit of body, and, conjoined with low diet 
and abundant exercise, will reduce corpulency more effica- 
ciously, and far more safely, than the absurd system which, 
under the fitting auspices of a London undertaker, has 
recently been so productive of evil in this country. 

In some affections dependent on an impoverished state of 
the blood, the Carlsbad waters act more beneficially than any 
of the strong ferruginous spas. This is probably owing to 
their stimulant and deobstruent qualities, by which the con- 
stitution is prepared for the action of the very small quantity 
of iron they contain. 

The table d'hotes at Carlsbad differ from those of almost all 
other German watering-places, in the simplicity of the fare 
and the paucity of the dishes. I have seen a newly arrived 
guest who allowed a few dishes to pass untasted, reserving 
himself for imaginary plats to come, surprised to find dinner 
concluded before he had tasted anything but the soup. In 
truth, invalids have here little temptation to gastronomic 
excess, and perhaps this explains in some degree the good 
effect of Carlsbad on dyspeptic and gouty patients. 



MARIENBAD. 197 



CHAPTEE XXXV. 

MARIENBAD AND FRANZENSBAD. 

Marienbad, which may be reached by the same route as the 
last described spa as far as Eger, from which it is only three- 
quarters of an hour's distance by train, is one of the prettiest 
of the continental spas. The town is quite modern, and con- 
sists entirely of hotels and lodging-houses built around three 
sides of an extensive park or garden, which contains most of 
the mineral sources. Nearly in the middle of this park is a 
very handsome church, built in the shape of a Greek basilica. 
This belongs to the monks of Topi, who are the proprietors of 
the town. 

The hotels being of enormous size, look quite out of pro- 
portion to the little town in which they stand, but are 
crowded to excess during the season. Where there are 
patients, there will, of course, be doctors ; and this is the 
case in Marienbad, where a dozen physicians besides three 
surgeons, reside in the various hotels from May to September. 

Marienbad, though one of the most beautifully-situated 
watering-places in Europe, must, I think, be a very dull 
residence for those who do not require its mineral waters. 
The Kursaal, at the extreme end of the park, is a large and 
handsome building, and besides this there are the usual 
assembly and concert rooms and a small theatre. Opposite 
to the windows of our hotel was the principal mineral spring 
— the Kreuzbrunnen, which, as is the case with all the 



198 



MARIENBAD. 



Marienbad springs, owes its therapeutic properties chiefly to 
the amount of sulphate of soda or Glauber's salts it contains. 

Composition of Marienbad Mineral Springs. 





Kreuz- 
bmnnen. 


Karolinen- 
brunnen. 


Ambrosius- 
bruimen. 


Ferdinanrls- 
brunnen. 


Sulphate of soda, . 
Chloride of sodium, 
Carbonate of soda, 
Carbonate of lime, 
Carbonate of magnesia, . 
Carbonate of iron, 
Carbonate of manganese, 
Carbonate of lithia, 
Silex, .... 




36-11 

11-16 

7-13 

3-93 
271 
0-17 
0-03 

o-ii 

0*38 


279 
0-82 
0-20 
3-66 
3-94 
0-44 

: 46 


1-86 

1-64 
1-66 
2-89 
2-72 
0-34 

0-48 


38-53 
15-39 
6-13 
4-10 
3-04 
0-39 
0-09 
0-06 
0-66 


Total solid contents in grain. 
Carbonic acid gas, in cubic 
inches, 


5 

1 


66- 


Hi 
15-43 


ioi 

12-9 


73-38 
13| 



The Marienbad waters act directly upon the liver, the secre- 
tion of which is notably increased by their use. Their first 
effect is that of a saline aperient, not followed, however, by 
the debility attending the exhibition of other equally powerful 
remedies of that class. On the contrary, the carbonate of 
iron they all contain, though in such small proportions, pro- 
duces a very decided tonic effect. The appetite is almost 
invariably sharpened by them ; the pulse is generally at first 
quickened, and the kidneys secrete more copiously under 
their influence. 

The Kreuzbrunnen, which is cold, is generally adminis- 
tered with a sufficient quantity of warm water to bring 
the temperature of the draught up to 90°. The usual 
dose as an aperient is from three to four glasses of this 
mixture. The special action of the Kreuzbrunnen is to 
stimulate all the abdominal organs, especially the liver, 
to increased action ; hence its curative effects in cases of 
general plethora, dsypepsia, hypochondriasis, as well as in 
some hysterical and uterine affections. 



MARIENBAD. 199 

The Karolmenbrunnen is the strongest tonic source in 
Marienbad, containing about half a grain of iron in a tumbler- 
ful of the water, as well as double the amount of carbonic 
acid gas found in the Kreuzbrunnen, and may be prescribed 
iu most cases of general and local debility requiring a fer- 
ruginous tonic, as also may the Ambrosiusbrunnen. 

The Marienquelle, the original spa of this place, is no 
longer used internally, being employed only for baths, which 
are here regarded merely as adjuncts to the use of the other 
springs. These baths almost invariably produce a powerful 
diuretic effect, and are prescribed in scrofulous glandular 
enlargements, chronic rheumatism, and torpidity of the liver 
and bowels, but cannot be used safely except under the 
supervision of a local physician. 

Mud Baths are used in Marienbad, but not to the same 
extent as at Franzensbad, in the following account of which 
place they will be described. 

Gasbdder, or gas baths, are also employed here, both locally 
and generally. In the latter form of bath the patient enters 
a square box, shaped exactly on the model of a Chinese 
pillory, covering the entire body except the head, which 
protrudes through a hole in the lid. Into this he is put, 
dressed in his ordinary habiliments ; the gas is let in through 
a pipe in the bottom of the box, and presently, as the gas 
rushes in, a sensation of tingling and pricking is felt creeping 
up the legs, and gradually extends over the entire body. The 
" gas -bad," which owes its medicinal application to Dr Sturve 
of Dresden, has now risen into great vogue with German 
physicians and patients in the treatment of some diseases 
marked by general torpitude and vascular languor, sup- 
pressed menstrual or hemorrhoidal discharges, and scrofu- 
lous ulcers. 

Prom Marienbad a drive of twenty miles by railway, 



200 



FRANZENSBAD. 



passing through, the historic town of Eger, brings us to 
Franzensbad, which is situated in the midst of a bog surrounded 
by bleak-looking mountains, and consists of four streets 
crossing each other at right angles, built on piles driven into 
the soft mud beneath. The principal street is the Kaiser- 
Strasse, a long boulevard planted with chestnut trees. This 
contains the chief hotels and bath-houses, and leads up to the 
Franzensquelle source. 

There are four mineral springs here, the composition of 
which will be seen by a glance at the following table : — 

Analysis of Franzensbad Mineral Waters. 





CT D 

a) a> 

Npq 


4) OS. 

So 


1? 
a* 02 

<u a 

s » 


P 

•11 




P 

fe —- 


£6 


£S 


3b 


Sulphate of soda, .... 


24-50 


21-52 


25-65 


21-41 


Chloride of sodium, 


9-23 


8-76 


9-32 


6-76 


Carbonate of soda, .... 


5-18 


5-20 


8-97 


5-49 


Carbonate of lithia, 


0-03 


0-02 


0-02 




Carbonate of magnesia, . 


0-67 


079 


0'61 




Carbonate of lime, .... 


1*89 


1-41 


1-37 


1-60 


Carbonate of protoxide of iron, 


0-23 


0-07 


013 


32 


Carbonate of protoxide of manganese, 


0-04 


0"01 


0-02 




Phosphate of lime, 


0-02 


0-02 


0-02 




Other salts, ...... 

Total solid contents (grains), 


0-47 


0-49 


0'46 


0-22 


42-18 


38-29 


46-58 


35-80 


Carbonic acid gas (inches), 


40 


26-88 


30'89 


32-54 



In their action, the Franzensbad waters resemble those of 
Marienbad, but, containing less sulphate of soda and more 
carbonic acid gas and iron, are not so lowering. The use of 
these springs is said to produce a sedative action on the 
nervous system, while imparting strength and tone to the 
muscles ; they also purify the blood by their purgative and 
diuretic action, and improve its composition by the additional 
nutriment which the patient is now enabled to digest. 



FRANZENSBAD. 201 

Therefore Franzensbad is largely resorted to by dyspeptic and 
hypochondriacal patients. 

Near the Franzensquelle is the Gasquelle or gas source, 
over which baths have been erected; the effects of which, 
being precisely the same as those of the gas-baths of Marien- 
bad, need not be again described. 

The mud-baths are the special advantages of Franzensbad, 
and are extolled as a cure for every disease under the sun, 
et quibusdam aliis. The soft boggy earth which surrounds 
Franzensbad on all sides is the material of these baths. It is 
dug up and repeatedly forced through sieves, until it is per- 
fectly free from all foreign matters, woody fibres, &c, and 
when it has attained a perfectly soft, homogeneous condition, 
is diluted into a semi-fluid, black, pultaceous mass, exhaling 
a strongly sulphurous smell, with the Louise nquelle water, 
heated to about 100°. Into this uninviting-looking bath the 
patient enters, and so dense is it, that it is generally some 
time before he can immerse his whole body. The use of 
these baths is by no means so unpleasant as their appearance, 
and the bather generally leaves with reluctance at the end of 
the quarter of an hour which is their usual duration; and 
then is placed in a plain tepid water bath, where he finds 
sufficient occupation for half an hour in restoring himself to 
something like cleanliness. 

The principal saline contents of this mud are sulphate of 
soda, lime, magnesia, iron, and aluminia, silica, tannin, sand, 
resinous and vegetable matters. 

The primary action of these baths is stimulant and excit- 
ing to the nervous system. They produce some degree of 
cutaneous irritation ; whilst in them the skin looks corrugated 
and wrinkled, but feels smooth and glossy immediately after 
emersion. The appetite is almost always increased by the 
external use of this mineralised mud. 



202 FKANZENSBAD. 

The Moorbader, as these mud-baths are called, are used 
in chronic arthritic and rheumatic affections, in skin diseases 
of an obstinate, languid character ; in similar ulcers ; in glan- 
dular swellings, in paralytic complaints, particularly of the 
lower extremities ; and are renowned for the cure of old and 
painful wounds. 



TEPLITZ. 203 



CHAPTEE XXXVI. . 

TEPLITZ, BILIN, PULLNA, AND SEDLITZ. 

Teplitz, which, next to Carlsbad, is the most important of the 
Bohemian spas, may be reached by railway with equal facility 
from Northern and Southern Germany, being only sixty- 
three miles from Dresden, and sixty from Prague. 

The town lies in a narrow and very fertile valley, well 
protected by the Erzgebirge mountains. Like the other 
Bohemian watering-places, Teplitz contains little, with the 
exception of its mineral springs, to attract tourists, being in 
all other respects a quiet little country town of about 6000 
inhabitants. The Bad-Platz, containing the chateau, is a 
handsome park surrounded by hotels, lodging-houses, assembly 
rooms, theatre, and bathing establishments. 

In the immediate vicinity of the town, and in the adjoining 
village of Schonau, there are no less than seventeen mineral 
thermal springs, differing only in temperature. 

These springs are all saline, alkaline, and slightly chalybeate, 
but are none of them of any chemical strength sufficient to 
explain their undoubtedly powerful medicinal effects, which 
in great measure must be accounted for by the high tempera- 
ture at which they are employed. The solid ingredients are 
about five grains to the pint of water, and chiefly consist of 
carbonate of soda. 

Subjoined is the analysis of the principal spring of Teplitz, 
as given by Dr Sutro* whose table differs somewhat from 
M. Wolf's as cited in Dr Seegen's work on mineral waters :f — 

* " Lectures on the German Mineral Waters," by Sigismund Sutro, M.D., p. 25. 
t " Handbuch der Heilquellenlehre," Von Dr Josef Seegen, p. 663. 



204 



TEPLITZ. 




Composition of the Hauptquelle. 




Grains. 


Sulphate of potash, 


. 0-43 


Carbonate of soda, 


. 2-68 


Carbonate of lithia, 


. o-oi 


Carbonate of lime, 


. 0-32 


Carbonate of strontia, . 


. o-oi 


Carbonate of manganese, 


. 0-08 


Carbonate of magnesia, 


. 0-05 


Carbonate of iron, 


. 0-03 


Chloride of sodium, 


. 0-43 


Chloride of potassium, 


. o-io 


Iodide of potassium , . 


. 0-05 


Phosphate of aluminia, 


. 0-02 


Silico-fluoride of sodium, 


. 0-13 


Silica, .... 


. 0-31 


Crenic acid, 


. 0-09 



Total solid ingredients in 16 ounces of water 4 -84 



Notwithstanding the similarity of their chemical composi- 
tion, the thermal waters of Teplitz differ so much in their 
therapeutic effects, that it would be quite unsafe to use any of 
them without first consulting a local practitioner as to the 
proper spring to be employed in each case. The principal 
source used internally is the G-artenquelle, which is a mild 
aperient and resolvent, said to be very efficacious in the 
treatment of chronic glandular and visceral enlargements. 

The principal use of the Teplitz springs is in the baths, 
which generally occasion a good deal of vascular excitement, 
or slight febrile disturbance, and after some days' employment 
commonly produce a red cutaneous eruption with great 
irritation of the skin. 

The Teplitz baths are used in the treatment of chronic 
rheumatic-arthritis and diseases of the joints, in spinal 
curvature and hip-joint disease, in cases of amenorrhcea 
and hysteria, in certain chronic skin diseases, in enlargements 
of the liver or spleen, hypochondriasis, and other chronic 



BILIN. 



205 



maladies in which a remedy which combines stimulant with 
tonic and resolvent properties is required. 

I need hardly add that these waters are especially contra- 
indicated in all acute inflammatory or haeniorrhagic diseases. 

Within nine miles of Teplitz, on the road to Prague, is 
Bilin, the so-called " Yichy of Germany." This little market- 
town of 3000 inhabitants lies about a mile from the remarkable 
basaltic mountain of the Biliner-Stein, and needs no descrip- 
tion here, being seldom resorted to by invalids, although its 
waters are largely exported. 

The chief ingredient of the mineral water of Bilin is 
carbonate of soda, of which it contains twenty-three grains in 
the pint, being five grains stronger than the Fachingen spa, 
to which it otherwise bears a close resemblance. The chief 
source is the Josefsquelle, the analysis of which, according 
to Dr Eedtenbacher, is as follows : — 



Composition of Bilin Mineral Water. 



Grains. 

Carbonate of soda, .... 23*106 


Carbonate of lime, 






3-089 


Carbonate of magnesia, . 






1-098 


Carbonate of protoxide of iron, . 






0-080 


Carbonate of lithia, 






0-110 


Sulphate of potash, 






0-985 


Sulphate of soda, 






6350 


Chloride of soda, 






2-935 


Basic phosphate of aluminia, 






0-065 


Silica, 






0-244 


Total solid ingredients, 


38-062 



The Bilin springs are employed in cases requiring an 
alkaline carbonated water, in diseases of the urinary organs 
and kidneys, in Bright's disease, in certain cases of gout, in 
jaundice, and in rheumatic affections of the joints. 

Twelve miles from Teplitz are the sources of the well-known 
bitter waters of Piillna, Saidschiitz, and Sedlitz. 



206 



PULLNA. 



The village of Piillna/on the road to Carlsbad, is the chief 
source whence the " Bitterwasser " is exported to every part 
of the civilised globe ; but as the water is very seldom drank 
on the spot, there is hardly any accommodation for invalid 
residents, beyond a very second-rate inn. The mode of 
collecting the "Bitterwasser" at Pullna is similar to that 
employed at Sedlitz and Saidschiitz, and may here be described 
once for all. These three sources are situated in an extensive 
marly plain, the soil of which for a limited area round each 
spring has a peculiar light yellowish colour, and is perfectly 
destitute of vegetation. In this marly clay, wells or tanks 
are dug, and the rainfall and oozing of the soil is suffered to 
accumulate in them for months, dissolving out the soluble 
saline ingredients from the subjacent formations. 

To return to Pullna, according to Professor Ticinus, the 
following is the analysis of 

Pullna Bitter Water. 





Grains. 


Sulphate of magnesia, 


96-975 


Sulphate of potash, 


82-720 


Sulphate of soda, 


123-80 


Chloride of magnesium, 


19-120 


Nitrate of magnesia, . 


4-602 


Carbonate of magnesia, 


6-280 


Sulphate of lime, 


0-800 


Carbonate of lime, . 


0-760 


Bromide of magnesium, 


0-588 


Phosphate of soda, 


0-290 


Total solid ingredients, 


222-900 



Together with 49 cub. in. of carbonic acid gas, in 16 ounces of the water. 

To the eastward of the last-described source in the same 
plain lies Sedlitz, or Seidlitz, whose name is the most 
familiar, and whose waters are the least used of all the 
German mineral springs. Sedlitz is a wretched-looking 
place, hardly meriting the name of a village, and the wells, 



SEDLITZ. 



207 



whence the water should be derived, are a few shallow 
circular pits, whose contents very seldom find their way to 
this country. The actual Sedlitz water differs in every 
respect from the " Genuine Sedlitz powder" of our chemists. 
Instead of the cooling agreeable draught composed of tartrate 
of soda and potash and bicarbonate of soda, set into effer- 
vescence with tartaric acid, used in England under this name, 
the true Sedlitz- wasser is a bitter, nauseous, yellowish-looking 
fluid, the composition of which is not less different from 
that of its English namesake than its taste, the following 
being the ingredients contained in 16 ounces of the 



Sedlitz Water. 






Grains. 


Sulphate of magnesia, 


104 


Sulphate of lime, .... 


8 


Carbonate of lime, .... 


8 


Chloride of soda, .... 


3 


Carbonate of magnesia, 


3 


Total solid contents, 


126 



With three and a half cubic inches of carbonic acid gas. 



Half an hour's walk from Sedlitz, on a slight elevation 
above the plain, is Saidschutz, the most largely exported of 
these waters. It is considerably stronger than the Sedlitz, 
and, according to Berzelius, the following is the analysis of 
16 ounces of 

Saidschutz Water. 





Grains. 


Sulphate of magnesia, 


84-16 


Nitrate of magnesia, 


2517 


Carbonate of magnesia, 


4-98 


Chloride of magnesium, . 


2-16 


Sulphate of potash, 


4-09 


Sulphate of soda, 


46-80 


Sulphate of lime, 


1007 


Oxides of manganese, iron, tin and copper, &c, 


0-28 


Total solid constituents, 


178-77 



208 SAIDSCHIJTZ. 

These " Bitter Waters," are aperient, resolvent, and diure- 
tic, varying in strength from the Piillna, which is the most 
powerful, to the Sedlitz, which is the weakest. They are 
all too strong, in general, to be used undiluted, and their 
action is quickened as well as rendered safer by mixture with 
an equal amount of warm water. They closely resemble 
the Friedrichshall spring, and are employed in the same 
class of cases — namely, in habitual torpidity of the intestinal 
canal, in congestions, torpidity, or enlargement of the liver 
and spleen, in plethora, in tendency to apoplexy and congestion 
of the brain, and similar diseases in which depletion is indi- 
cated. I have prescribed them extensively in the treatment 
of habitual constipation and hypochondriasis, and also more 
especially in the chronic diseases peculiar to women, in lieu 
of the drastic pills or draughts such patients seem so fond of 
taking. The usual dose is half a large tumblerful of the 
bitterwasser, with an equal quantity of hot water every 
morning, and may be repeated at intervals of two hours 
until the required effect is produced. 



GASTRIN. 209 



CHAPTER XXXVIT. 

GASTEIN, ISCHL, AND BADEN NEAR VIENNA. 

Within the same empire as the spas last described are two of 
the most important health resorts on the Continent, viz., 
Gastein and Ischl, both situated in the midst of the 
Noric mountains in Upper Austria. The first-named water- 
ing-place may be reached in three days and a half from 
London, via Munich and Salzburg. From Salzburg a drive of 
some fifty miles, occupying about fourteen hours by diligence 
or carriage, through magnificent Alpine scenery, and through 
the wild and sombre defile of the Klamn Pass, brings us into 
Wildbad- Gastein. 

This village, if it may be so called, is one of the most ex- 
quisitely situated, but most primitive-looking, watering-places 
in Europe. It is built at an elevation of upwards of 3000 feet 
above the sea, on the side of a steep mountain, along which 
some quaint ancient wooden houses, a long covered gallery, 
known as the " Wandelbahn," that serves as a cursaaL to- 
gether with a few modern stone buildings and hotels, are 
thinly scattered. Immediately below the village is a deep 
ravine, through which a mountain torrent, the Eiver Ache, 
rushes impetuously, forming two fine waterfalls, the incessant 
din of which is one of the most noticeable features of this 
place. 

The warm springs of Gastein, some six or seven in number, 
belong to the class of chemically indifferent thermal waters, 

o 



210 ISCHL. 

and vary in warmth from 115°, which is the temperature of the 
Haupt-quelle, to 118°, which is that of the Spital-quelle. Dr 
Proll of Gastein enumerates no less than fourteen salts which 
have been discovered in these waters * But as the sum total 
of all these saline ingredients is only 2 J grains in each pint of 
the water, it will be sufficient to mention that the chief of 
these is sulphate of soda with traces of chloride of sodium, 
sulphate of potash and carbonate of the protoxide of iron. 
It is obvious that such homoeopathic quantities of any of these 
constituents as is contained in the ordinary dose of the 
Gastein water is quite insufficient to account for the undoubted 
powerful therapeutic effects that occasionally follow a course 
of these waters and baths. But without seeking to explain 
the modus operandi of this spa, we may briefly mention the 
cases in the Gastein baths, and the internal use of the waters, 
are recommended. Having before pointed out the cases in 
which other spas of the same class are employed, I need only 
state in addition to those ailments in which Schlangenbad, 
Wildbad, or Pfeffers are prescribed, namely rheumatic gout 
and chronic rheumatism, contractions of the joints, neuralgia, 
hysteria, and hypochondriasis, the pure atmosphere of this 
charming mountain sanatorium renders Gastein peculiarly 
suitable for valetudinarians who require not only a course of 
the baths or waters, but also the tonic and invigorating 
influence of the bracing climate. 

Ischl, the favourite health resort of the Emperor of Austria, 
and hence the most fashionable and expensive of the Austro- 
Hungarian spas, is situated in the very centre of that vast and 
beautiful imperial domain generally known as the Salz- 
kammergut, which intervenes between the confines of Styria 
and Salzburg. This watering-place may be reached by 

* "Gastein, Erfahrungen und Studien," Von Dr Gustav Proll, "Brunneartz 
in Bad. Gastein," p. 88. 



BADEN, NEAR VIENNA. 211 

railway from Vienna to Gmunden in nine hours, and 
thence by carriage in three hours. The saline springs of 
Ischl have been well known and largely employed for the 
manufacture of table salt ever since the commencement of the 
twelfth century, but only within the last fifty years have they 
been applied to medicinal purposes, and hence the handsome 
town of some 5000 inhabitants, well provided with hotels, 
casino, theatre, and all the ordinary attractions of a fashionable 
German watering-place, is entirely modern. 

The baths of Ischl are divided into saline brine baths, or 
" Soolbader," and saline vapour baths, or " Soolendampf- 
bader." The former are made by the addition of the strong 
brine from the adjacent salt mines to a sufficient quantity of 
warm water. This brine or " soole " consists of two parts of 
the Hallstadt spring, with one part of the Ischl saline water, 
and is added in quantities varying from ten to thirty pints of 
brine to the bath, which is heated to about 90°. According 
to Professor Schrotter, the chief ingredients of one pint of 
this mixed brine or " Ischl-bade-soole," are 223 grains of 
common table salt, with traces of chloride of magnesia, bromide 
of magnesia, and sulphates of soda, potash, and lime.* The 
principal use of the Ischl baths is in the treatment of scrofulous 
diseases, rickets, chronic rheumatism, amenorrhea, and some 
instances of sterility dependent on defective ovarian action, 
suppressed haemorrhoids, certain cases of hysteria and hypo- 
chondriasis. 

Within three quarters of an hour's journey from Vienna 
by the Trieste Eailway, is the ancient watering-place of 
Baden-bei-Wien, which is prettily situated on the Schwe- 
chat, at the foot of the Wienerwald Mountains. This spa 
is a favourite holiday resort of the Vienese bourgeois ; and 
many of the baths, such as the " Herzogsbad," are vast 

* " Ischl sur le Keport Medical," &c, par le Dr J. Pollak, p. 56. 



212 BADEN, NEAR VIENNA. 

reservoirs of warm mineral water, capable of containing a 
couple of hundred bathers at a time, who, clad in a becom- 
ing costume, and surrounded by the crowds of spectators 
that fill the galleries above the baths, appear to seek amusement 
fully as much as health. But, though thus employed by 
those who do not require them, the thermal baths of Baden 
have been long esteemed as active therapeutic agents. These 
springs, of which there are here thirteen, were known to the 
Eomans as the Thermce Pannonicce, and vary in temperature 
from 98°, the Josefsquelle, to 79°, the Peregrinusquelle. The 
chief saline ingredient of the Baden waters is sulphate of lime, 
of which they contain 5 grains to the pint, together with 2 
grains of sulphate of soda, smaller quantities of the chlorides 
of magnesia, soda, and other salts, amounting in all to 14 
grains of saline matter, and 2 cubic inches of carbonic acid, 
sulphuretted hydrogen, and nitrogen gas. The principal use 
of these baths is in the treatment of chronic rheumatism 
and rheumatic arthritis, scrofulous glandular enlargements 
and chronic skin diseases, especially those connected with 
the scrofulous diathesis. 



CANNSTATT. 



213 



CHAPTEK XXXYIIL 

CANNSTATT AND WILDBAD, 

Wurtemberg possesses two watering-places of considerable 
importance. The first of these is Cannstatt, on the Neckar, 
about three miles from Stuttgart. 

There are no less than eighteen or twenty saline chalybeate 
springs in Cannstatt. 

Analysis of the Principal Springs of Cannstatt (Fchling). 



Chloride of sodium, 
Chloride of potassium, 
Chloride of magnesium, 
Carbonate of lime, 
Carbonate of magnesia, 
Carbonateof protoxide of iron 
Sulphate of soda, 
Sulphate of magnesia 
Sulphate of lime, 
Sulphate of potash, 
All other ingredients, 

Total solid contents, 
Carbonic acid gas, 



c 
'So 

11 
cct 


.22 * 

"V. — 

c 3 


*3 

CO 




3c4 

N 


16-29 


19-50 


16-42 


12-63 


7-59 




0-25 




0-87 


0-57 




0*18 








7-89 

... 


7-38 
0-31 


8-82 


7-95 


6-40 


0-16 


0-25 


0-18 


0-17 


0-02 


2-92 


4*75 


2-18 


0-87 


1-04 


3-53 


2-25 


3-51 


3-89 


3-34 


6'43 


7-75 


6-32 


6-88 


5-06 


1-23 




1-38 






0-16 




0-17 


0-09 


0-08 


38 61 


42-62 


38-98 


33-45 


24-10 


23-5 


19-4 


27'7 


14-6 


8-8 



The Cannstatt springs owe their efficacy to the combination 
of different purgative salts, together with a small quantity of 
iron, rendered peculiarly active and soluble by an excess of 
Thus they combine aperient with slightly 



carbonic acid gas. 



214 CANNSTATT. 

tonic properties, They are, therefore, valuable deobstruent 
remedies, and are also frequently prescribed by the physicians 
of Stuttgart in dyspeptic cases. The principal use, however, 
of these springs, is in cases where a mild tonic is indicated 
in chronic catarrhal affections of the mucous membrane, and 
in some scrofulous diseases. 

The " Sprudel " spring is that most frequently prescribed. 
There is another celebrated source which is used principally 
for bathing, " Die obere Sulzquelle," a small pond of about half 
an acre diameter, formed by several springs. The water is so 
gaseous that it seems absolutely boiling, so hissing and 
bubbling is it with nitrogen and carbonic acid gases. The 
temperature is about 66°, and its medicinal use is chalybeate 
and solvent, being especially employed, in the form of local 
douche baths, in the treatment of catarrhal affections of 
the utero-vaginal and vesico-rectal mucous membranes. 

Wildbad, the most romantically-situated of the German 
watering-places, is beautifully placed in the very centre of the 
Black "Forest, about six hours' journey by railway from 
Stuttgardt, and four hours' from Carlsruhe. From Pforzheim 
the branch line to Wildbad passes through the valley of the 
Enz, the narrow strip of land between which and the forest 
is cultivated with a care which throws Mr Mechi's model 
farming completely into the shade. Through the midst of 
this the Enz, here the noisiest and most turbulent mountain 
stream of its size that can be imagined, rushes white with 
foam, and bearing rafts so narrow, although longer than the 
" Great Eastern," that they hardly afford footing to the man 
who navigates them, down to the distant Ehine ; while back 
from the river extend for miles on either side the gloomy 
pine-shades of the Black Forest. 

On our arrival at Wildbad, having secured our rooms at 
the Hotel Klumpp, — which, I may remark, is one of the most 



WILDBAD. 215 

comfortable hostelries in Germany, though there are several 
others, perhaps equally good, here, — I called on Dr Haussmann, 
to whom I had letters of introduction, and to his courtesy 
and assistance I am indebted for much of the information I 
obtained concerning this watering-place. 

Wildbad, which stands in the narrowest part of the valley of 
the Enz, contains a population of about 3500 inhabitants. The 
Grand Bath House or Curhaus, which is opposite to the Hotel 
Klumpp, is the most perfect bath establishment in Europe for 
its size. Of its extent some idea may be formed from the fact 
that twelve hundred baths can be daily administered, each 
bath being, moreover, of considerable duration. The founda- 
tion of this building is cut out of the solid granite rock, 
through which the water percolates, and on which the baths 
lie with the intervention of a thin layer of fine sand. The 
establishment is equally apportioned to male and female 
baths. In both are large public "piscina?," and smaller 
cabinets for those who prefer bathing separately. One cha- 
racteristic of all these baths is the great height of the rooms, 
so that one is not plunged into a hot vapour bath before 
entering the water, as is the case in almost every other 
bathing establishment in Germany that I have visited. The 
water is remarkably clear, so that every grain of sand at the 
bottom is distinctly visible, although covered by some three feet 
of water, through which minute bubbles of gas are continually 
ascending. The temperature in the principal piscina is 96°, 
and in the other baths it varies from 92 to 103°. 

The arrangements of this establishment are excellent; and 
the precautions taken to prevent those afflicted with con- 
tagious and horrifying diseases from bathing in the public 
baths, are especially deserving of imitation in every similar 
institution. 

The reputation of Wildbad as a spa is of very ancient date, 



216 



WILDBAD. 



and in the reign of Charles V., by the gratitude of some 
courtier who here regained his health, a curious charter 
was obtained for this town, which contained a proviso that 
" all criminals, with the exception of murderers and highway 
robbers, might here enjoy peace and quiet undisturbed, for a 
year and a day." 

According to Fehling, the following is the 

Analysis of Wildbad Water. 





Grains. 


Sulphate of soda, . 


0-29 


Sulphate of potash, 


010 


Chloride of sodium, 


1-80 


Carbonate of soda, 


0-83 


Carbonate of magnesia, 


0-07 


Carbonate of lime, 


0-73 


Carbonates of iron and manganese, 


0-02 


Silex, ..... 


0-48 


Total, . 


4-35^ 



The gaseous constituents of this water have probably more 
to do with its therapeutic effects than its saline ingredients, 
and are very abundant, 100 parts consisting of 91*56 of 
nitrogen, 6 "54 oxygen, and 2*00 carbonic acid gas. 

These constitutents, solid or gaseous, are, however, insuf- 
ficient to account for the active therapeutic properties of 
Wildbad water. Some writers ascribe these solely to its 
temperature, which is 98°, or exactly that of the blood. 

With respect to the modus operandi of these springs, Dr 
Haussmann's theory is, that the Wildbad water contains no 
lime whatever, although it is a very powerful solvent of that 
base, and therefore that it acts by dissolving and removing the 
salts of calcium which exist in excess in the blood and tissues. 
He also gave it as his opinion that by increasing the fluidity 
of the blood it thus facilitates the elimination of morbid 
materials from the system, and in part also obtains the same 

*" Handbuch der HeilqueUenlehre," p. 652. 



WILDBAD. 217 

result by stimulating the excretory organs, especially the 
kidneys and skin. 

The first effect of the Wildbad baths is a peculiar sense 
of comfort, or bien-etre, which has been, I think, somewhat 
exaggerated by most writers. Succeeding to this is a slightly 
stimulant or exhilarating influence, which, if the bath be too 
long continued, is followed by a feeling of lassitude and a 
soporific tendency. Therefore the local physicians enjoin their 
patients to commence with a bath of ten minutes' duration, 
which may be gradually increased until it at last reaches half 
an hour's immersion, beyond which it will be very seldom, if 
ever, proper to prolong the bath. After some time the patient 
will generally experience the symptoms of what has been 
already described as the spa fever, or saturation point, and this 
usually proves critical, and is a precursor of the cure of the 
ailment for which the invalid has visited Wildbad. 

These baths are largely employed in the treatment of 
neuralgia and sciatica, in some of the diseases peculiar to 
women which are connected with chronic uterine or ovarian 
inflammation, also in cases of functional amenorrhcea; in 
various scrofulous glandular affections, and above all in 
rheumatic gout and chronic rheumatism. In the last-named 
complaint it is indeed that Wildbad seems to exercise its most 
marked curative effect; more especially is this sanative 
influence shown in cases of chronic rheumatic-arthritis, in 
which the action of the joint is impaired, or even its form- 
altered, by morbid deposits. Such structural changes are 
often rectified, and the effused matter absorbed by the com- 
bined internal and external use of this, apparently, simple 
water, when more pretentious remedies have been long tried 
in vain. 



218 BADEN-BADEN. 



CHAPTER XXXIX. 



BADEN-BADEN. 



The " Queen of the Spas," as Baden has been designated, is 
but six hours from the watering-place described in the last 
chapter, and within thirty-two hours' journey from London. 
The situation of Baden, on the declivity of the Schlossberg 
overlooking the valley of the Oosbach, is exquisite ; the hotels 
and lodging-houses are commodious ; the people are civil ; the 
shops are good ; the resources for the amusement of visitors are 
numerous ; and the mineral springs, which are recommended 
in almost all chronic diseases, may be found really useful in 
some cases. 

Baden is divided into two distinct towns — the old and the 
new, — the buildings of which are as different as their popula- 
tions. The former, which is situated on the hill, consists of 
narrow lanes of quaint, old-fashioned houses, rising in succes- 
sive terraces, is peopled by the indigenous inhabitants, and 
contains the mineral sources. The new town occupies the 
valley on the south side of the river, and contains the 
" Trinkhalle," or pump-room, the public gardens, and numerous 
villas and boarding houses. This part of the town is exclu- 
sively populated by the foreign element, and it would be 
difficult to find a dozen large houses here which are not either 
hotels or lodging-houses. 

The principal spring of Baden is the Ursprung, which 



BADEN-BADEN. 



219 



resembles the Kochbruimen of Wiesbaden, being a warm 
saline water, but is much weaker. 



Analysis of the Ur sprung, by Bunsen. 



Chloride of sodium, 
Chloride of magnesium, 
Chloride of potassium, 
Phosphate of lime, 
Sulphate of lime, 
Sulphate of potash, 
Carbonate of lime, 
Carborate of magnesia, 
Carbonate of ammonia, 
Carbona.te of protoxide of iron, 



Grains. 

16-52 

0-09 
1-25 
0-02 
155 
001 
0-88 
0-02 
0-03 
0-91 



Total solid contents in a pint of the water, . 21*35 
Carbonic acid gas rather less than a cubic inch. 

The Baden-Baden waters are used both internally and 
externally. The cases in which Baden is resorted to are very 
similar to those in which Wiesbaden is indicated. During 
each of my visits to Baden-Baden I met with patients suffering 
from a mild form of chronic rheumatism, who seemed to have 
derived benefit from this remedy. It is also admissible in 
some cases of neuralgia ; and Dr Edwin Lee records its 
virtues in instances of "nervous affections of a convulsive 
nature, such as hysteria, with congestions of internal organs 
and irregularity in the performance of periodical functions."* 
It is prescribed with occasional advantage in the treatment of 
dyspepsia, and in irritability of the vesical and intestinal 
mucous membranes. 

Dr Seegenf says that Baden water is indicated in the 
treatment of chronic catarrh of the respiratory organs. I 
should, however, hesitate to send any patient of mine suffer- 



* " The Baths of Germany," by Edwin Lee, M.D., 3d edition, p. 168. 
t " Handbuch der Heilquellenlehre, " Seegen, p. 446. 



220 BADEN-BADEN. 

ing from chronic bronchitis to so variable a climate as 
this, unless the disease were clearly connected with the 
gouty diathesis. It is also employed in scrofulous affections 
of the glands and skin, and, by the resident physicians, in 
almost every other disease. 



THE SWISS BADEN. 



221 



CHAPTEE XL. 



THE SWISS BADEN. 



Baden-on-the-Limmat, in the Canton of Aargau, is the 
oldest known watering-place in Switzerland, and may be 
reached by railway from Bale in a couple of hours. The 
town, which is evidently of great antiquity, is situated in part 
on a kind of platform overhanging the river, and in part in the 
ravine through which the stream flows. At the south end of 
the place a curious antique covered bridge crosses the river, 
and at the opposite extremity are situated the mineral baths 
and springs. The principal source issues immediately in front 
of the Schweizer hoteL 

This spring is warm, very gaseous, and strongly sulphurous. 



Analysis of Baden Mineral Water, by Lowig. 



Grains. 



Sulphate of soda, 








2-218 


Sulphate of magnesia, 








2-442 


Sulphate of lime, 








10-860 


Chloride of potassium, 








0-711 


Chloride of sodium, 








13-042 


Chloride of magnesium, , 








0-566 


Carbonate of lime, 








2-599 


Carbonate of magnesia, 








0152 


Carbonate of strontium, 








0-005 


Fluoride of calcium, 








0-016 


Chloride of calcium, 








0-719 


All other ingredients, 








0-013 


Total solid contents, 


33-343 



Baden was frequented as a watering-place by the Bomans, 



222 THE SWISS BADEN. 

and numerous relics of this bath -loving people have been 
found in the environs of the springs. In the Middle Ages 
Baden was more resorted to than at the present day, and 
Poggio Bracciolini, the celebrated Roman scholar and courtier 
of the fifteenth century, in a letter written in 1415, has left a 
graphic account of a fashionable watering-place of that day : 
" I write to you," he says, " from these baths, to which I have 
now come, to try whether they can remove an eruption which 
has taken place between my fingers ; to describe to you the 
situation of the place, and the manners of its inhabitants, 
together with the customs of the company who resort hither 
for the benefit of the waters. . . . They are resorted to by 
males and females, who are separated by a partition. In this 
partition, however, there are windows, through which they 
can converse with each other. Above the baths are a kind of 
gallery on which the people stand who wish to see and 
converse with the bathers ; for every one has free access to the 
baths, to see the company, to talk and joke with them. The 
bathers frequently give public dinners in the baths, on a table 
which floats on the water . . . and they spend the greater 
part of their time in the baths, where they amuse themselves 
with singing, drinking, and dancing."* 

Two centuries later, an old English traveller gives the 
following description of the baths of the Swiss Baden, as they 
existed in 1617: — "These baths," says Fynes Moryson, "are 
famous for medicine, and are in number thirty, seated on each 
side the brooke, which divideth them into Bethora, the great 
and the little. In the great, divers baths are contained under 
one roof of a house, and without the gate are two, common to 
the poore. These waters are so strong of brimstone^ as the 
very smoak warmeth them that come neere, and the waters 

* "The Life of Poggio Bracciolini," by the Rev. William Carpenter, pp. 
69-76, Liverpool, 1802. 



THE SWISS BADEN 223 

burn those that touch them. Of these, one is called the 
Marques Bath, and is so hot as it will scald off the haire of a 
hogge. The waters are so cleere as a penny may be seen in 
the bottome, and because melancholy must be avoided, they 
recreate themselves with many sports, while they sit in the 
water ; namely, at cards, and with casting up and catching 
little stones, to which purpose they have a little table swim- 
ming upon the water, upon which sometimes they doe likewise 
eate. These baths are very good for a cold braine, and a 
stomach charged with rhume ; but are hurtful to hot and dry 
complexions, and in that respect they are held better for 
women than men."* 

At the present time Baden-on-the-Limmat is frequented 
by few except Swiss valetudinarians, or invalids from the 
neighbouring German states, during the season, which lasts 
from June to September. It is a quiet, and somewhat 
triste, though beautifully- situated watering-place. These 
baths and waters are principally employed in the treatment 
of some obstinate skin diseases, in secondary and tertiary 
syphilis, and also in chronic rheumatism and gout, with 
exudation into the joints. 



* "An Itinerary written by Fynes Moryson, Gent., containing his Ten 
Years' Travels," &c, Part I. bk. i. p. 26, folio, London, 1617. 



224 



SCHINZNACH. 



CHAPTER XLI. 



SCHINZNACH AND WILDEGG. 



Retkacing our steps towards Bale, half an hour's journey 
by train from Aargau brought us to Schinznach where, as at 
some other Swiss watering-places, there is neither town nor 
village, but merely a vast bathing establishment, in which 
those who go through a course of the water must live in 
community, isolated from the rest of the world. 

This spa may now be easily reached from London, either by 
Paris and Strasbourg, or by the Great Luxemburg Railroad, 
via Bale, in two days. The bath-house, which overlooks the 
river Aar, was commenced in 1695 and reconstructed recently, 
contains excellent accommodation for about four hundred visi- 
tors. At a short distance from this is a sanatorium, where 
seventy-six poor patients are well cared for at a nominal charge. 

Schinznach is the strongest sulphurous water in Switzer- 
land. The following is a recent analysis of this source : — 



Chloride of sodium, 
Chloride of potassium, ) 
Chloride of ammonia, / 
Sulphate of soda, 
Sulphate of lime, 
Sulphate of magnesia, 
Carbonate of lime, 
Carbonate of magnesia, 
Aluminia, 
Silicic acid, 



Total solid ingredients 



Grains. 
5001 

0-063 

0-919 

4-886 
2-052 
1-086 
0-063 
0-045 
0-086 

14-201 



SCHINZNACH. 225 

Cubic Inches. 

Sulphuretted hydrogen gas, . . . 1*268 

Carbonic acid gas, .... 1'886 

Nitrogen, ..... Traces. 

The most important constituent in this water is the sul- 
phuretted hydrogen gas, the physiological effects of which 
vary according to the dose, — a small dose being a tonic, while 
a large one is a very powerful stimulant. Its principal use is 
in the baths. When used internally, it must first be allowed 
to remain exposed to the air for some time after being 
drawn from the source, for the purpose of admitting of the 
escape of a large proportion of the gas it contains. 

When drank with the precaution I have mentioned, the 
Schinznach water acts as a stimulant and resolvent ; it ex- 
cites the activity of the gastro-intestinal mucous membrane, 
accelerates the pulse, and determines to the skin. According 
to Dr Amsler, this spa has a peculiarly stimulating effect 
on the pulmonary mucous membrane, being specially con- 
traindicated and likely to be injurious in any bronchial or 
pulmonary complaint, and in any organic visceral disease 
whatever, or even for patients of a full plethoric habit of 
body. 

A course of the Schinznach baths generally produces 
a specific cutaneous eruption, which is regarded as a proof 
that the patient's system is under the influence of the 
remedy. This point is insisted on as of great importance, 
and is watched for with the same care that we examine the 
gums of a patient under a mercurial course. 

Dr Amsler and other local writers believe that nearly all 
chronic skin diseases, more especially eczema, psoriasis, and 
pityriasis may be cured by these baths. 

Scrofula, next to skin diseases, is the malady which brings 
most patients to Schinznach. The stimulant action of the 
water on the glandular system renders it peculiarly adapted 

p 



226 WILDEGG. 

for scrofulous diseases, either external or mesenteric. In 
cases of chronic rheumatism I was here assured that this 
spa is almost a specific, and in some cases of dyspepsia and in 
diseases occasioned by deficient or irregular menstruation, the 
stimulant properties of this very powerful sulphurous spring 
are occasionally beneficial, but in all cases, for reasons already 
stated, it must be used with much caution and under medical 
advice. 

The season lasts from May to September, inclusively, and 
the mode of using the water is the same as at other strong 
sulphurous baths, externally in douche, vapour, and other 
baths, as well as internally in doses of from one to two small 
glasses, morning and evening. 

Close to Schinznach is Wildegg, where a strongly saline 
iodated spring was discovered in 18S0, the water of which is 
now largely exported. 

The source of Wildegg rises through an artesian well some 
three hundred feet deep, which furnishes so small a supply 
that it can hardly fill fifty small bottles daily. Wildegg 
belongs to a class of mineral waters of which we have com- 
paratively few examples, namely, the iodated and bromated 
spas. According to Dr Laue,* the following is the analysis of 
this spring :— 





Grains. 


Iodide of sodium, 


0-218112 


Bromide of sodium, 


0236544 


Chloride of sodium, . 


80-236800 


Chloride of potassium, 


0-039936 


Chloride of lime, 


1-980672 


Chloride of magnesium, 


12-451584 


Chloride of strontium, 


0-152832 


Hydro-chloride of amonium, 


0-049152 


Sulphate of lime, 


14-172672 



* " Etudes sur les Eaux Minerales de Schinznach et de Wildegg," par A. 
Hermman, p. 22. 



WILDEGG. 227 

Analysis of Wildegg continued. 



Nitrate of soda, 
Carbonate of lime, 
Carbonate of iron, 
Silicic acid, 



Grains. 
0-339456 
0-583680 
0061400 
0-030720 

110-553600 



Total solid contents of 16 ounces, 
Carbonic acid gas, . . 2 "36 cubic inches. 

Small as the amount of iodine and bromine in the Wildegg 
spa may seem, when compared to the great strength of its 
other saline constituents, it is to these salts that it owes 
its reputation as a remedy of remarkable efficacy in the treat- 
ment of chronic glandular and scrofulous diseases ; the iodine 
and bromine stimulating the absorbent system, and thus dis- 
sipating indolent tumours. 



228 RAGATZ. 



CHAPTEE XLIL 

RAGATZ, PFEFFERS, THE ENGADINE, ST MORITZ, TARASP, 
AND LEUK. 

Comparatively few travellers for health row resort to 
Pfeffers or Pfaffers, as some call it, although many visit the 
adjoining village of Eagatz, which has become one of the 
most frequented watering-places in Switzerland, being within 
nine hours' journey of Zurich by railway, and three-quarters 
of an hour from Coire on the road to the Yia-Mala. The 
situation of Eagatz, at the entrance of the wild gorge of the 
Tamina, and the view from the hotel of the extensive valley 
surrounded with snow-clad mountains which extend before it, 
are most picturesque. The principal hotels, the Eagatz-Hoff 
and Hotel de Tamina, are excellent, and have commodious 
bathing establishments attached to them. But as these are 
supplied from Pfeffers, some miles distant, and as the curative 
effects of this water are, probably, more connected with its 
thermal condition than with its chemical composition, there 
can be no therapeutic advantage in using the baths at Eagatz 
instead of at their source. 

From Eagatz, a steep, winding road, immediately behind 
the hotel, brought us to the cliffs which overhang the Tamina, 
along the left bank of which the path is cut through the rock3. 
This road here and there descends to the level of the water 
and then rises to the edge of the precipice above it. In some 
places it is carried through short tunnels in the rock; and 
nowhere is the route devoid of picturesque beauty, and often 
passes through wild and sublime scenery. 



PFEFFERS. 229 

The ancient convent, now the bath-house of Pfeffers, is 
built on a narrow ledge of rock above the torrent, and is over- 
shadowed by the opposite precipice, which, rising five hun- 
dred feet, keeps the house in perpetual shade. The building 
is a long, narrow edifice, six stories high, and at the time of 
our visit, when the season was nearly over, looked exactly like 
a deserted cotton factory. This establishment, which is the 
property of the government of the canton St Gall, contains 
accommodation for about three hundred visitors. 

Immediately beyond the bath-house the ravine of the 
Tamina contracts to a crevasse not quite thirty feet in width, 
over which the precipices on either side, sloping towards each 
other, form a limestone roof four hundred feet high, and thus 
enclose a long cavern lighted by the few rays that find their 
way through the fissures where the rocks above meet. 
Along this the pathway to the thermal sources passes for 
nearly half a mile, midway between the roof and the abyss 
through which the torrent rushes ; the passage being sup- 
ported partly on a narrow ledge of rock projecting over the 
river, and in part on stakes driven into the marble walls of 
the crevasse. 

At the extremity of this pathway are situated the thermal 
sources to which Pfeffers owes its fame. They both rise 
within a few yards of each other, at the bottom of a cavern 
on the right bank of the Tamina. These springs have neither 
taste nor odour, are perfectly limpid, have the specific gravity 
of common water, and issue from the fountain at the tempera- 
ture of 99°. 

The thermal source of Pfeffers was first discovered in 1038, 
by a huntsman who, alarmed by seeing steam rising from the 
ground before him, turned back from the chase, and com- 
municated his discovery to the monks of the adjacent convent. 
By them it was utilised for the benefit of the poor of the 



230 



PFEFFEKS. 



district, and its fame gradually spreading, the first thermal 
establishment was opened in 1242, and patients were 
admitted — the poor gratuitously, and the rich for whatever 
offerings they might choose to make on their departure. Thus 
these baths flourished till 1838, when the government of the 
canton dispossessed the monks, and turned the monastery into 
an hydropathic establishment. 

From that time Pfeffers has become, year by year, less 
frequented by invalids, who now seem to prefer the modern 
establishment at Eagatz. The waters of Pfeffers belong to 
the same class as Gastein and "Wildbad, which possess hardly 
any chemical ingredients, and depend for their action on their 
temperature. 

Analysis of Pfeffers Spa, according to PagenstecJun 

drains. 

Sulphate of soda, .'.%■.-.* 0242 

Sulphate of potash, 
Chloride of sodium, 
Sulphate of lime, 



Carbonate of lime, 
Carbonate of magnesia, 
Other salts, 

Total solid contents, 



0-004 
0-208 
0-027 
0-910 
0-147 
0148 

1-792 



The principal use of the thermal sources ef Pfeffers is in 
the baths, in which the patients sometimes remain for a con- 
siderable time, though now they no longer stay as formerly, 
when, as an old author assures us, — "Multa dies noctesque 
thermis non egrediuntur ; sed cibum simul et somnium in his 
capiunt." 

The average duration of each bath at present is reduced 
to about twenty minutes. The same peculiar sense of 
bien-etre is ascribed to them as to the Wildbad baths, and it 
is certain that they exercise a remarkably sedative, but not 
depressing, influence on the system. After a few days, a slight 



PFEFFEES. 231 

febrile reaction comes on, during the course of the baths, 
which is regarded as critical. 

Long, indeed, would be the list, if I merely enumerated the 
diseases which the special writers on Pfeffers and Eagatz say- 
may be cured by these waters. I shall, however, only allude 
to those ailments which my own experience leads me to think 
are most susceptible to their therapeutic influence. 

Foremost amongst these complaints is dyspepsia and 
gastralgia, and it is remarkable in what large doses even the 
most irritable stomach tolerates the water, and how rapidly the 
best effects — diminution of pain, regular alvine action, and 
increased appetite — often follow its use. 

Nervous and spasmodic affections are frequently benefited 
by Pfeffers spa, which soothes and tranquillises the nervous 
system in a special manner, and cases of intractable neuralgia, 
sciatica, nervous headache, and similar complaints, are some- 
times cured by a few weeks' use of these baths, and the 
internal administration of the waters. 

The same remarks may be made of hysteria, chorea, and 
some other obscure nervous maladies. Also in renal and 
vesical complaints, such, for instance, as catarrh of the 
bladder ; even when the secretion is attended with pain, the 
passage through the system of so large a quantity of bland 
fluid as is daily drank at Pfeffers or Eagatz is likely to be 
attended with the best effects. 

Prom Eagatz an hour's journey by train brings us to Coke, 
the ancient capital of the G-risons, where the visitor to the 
health-resorts of the Engadine must revert to the primitive 
diligence, by which, in from ten to twelve hours, he may traverse 
the forty miles of mountain drive by the Julier Pass, which 
lies between Coire and St Moritz. This watering-place, 
although strongly recommended by Paracelsus in the sixteenth 
century, was, until recently, almost unknown to British valetu- 



232 THE UPPER ENGADINE. 

dinarians, by whom it is now crowded, not only on account of 
its chalybeate spa, but still more on account of its pure bracing 
mountain atmosphere. 

The situation of St Moritz in the exquisitely beautiful 
valley of the Upper Engadine, surrounded by the Grison moun- 
tains, and immediately below the Julier Pass, at an elevation 
of six thousand feet above the sea, and overlooking the valley 
of the Inn and its many lakes, which are generally frozen over 
until late in summer, although most picturesque, in my opinion 
renders this village quite unsuitable for the consumptive and 
bronchitic patients by whom it is now so largely frequented. 
The climate of the Upper Engadine, bracing and invigorating 
as it unquestionably is for those who can withstand its low 
temperature, being not only extremely cold at all seasons, but 
also probably the dryest in Europe, is far too stimulating for 
those suffering from pulmonary or bronchial irritation, and 
should be carefully restricted to those cases which I have 
pointed out in the first chapter of this work as requiring the 
tonic influence of a very pure, dry, cold, and bracing atmosphere. 
To such patients, and especially those suffering from anaemic 
disorders resulting from over- work and nervous exhaustion, the 
Upper Engadine, from Maloja to Samaden, may be regarded as 
the type of that '•' Happy Valley, wide and fruitful, surrounded 
on every side by lofty mountains," where Easselas discovered the 
tedium of uninterrupted repose, and experienced the irresist- 
ible craving " to see the miseries of the world, since the 
sight of them is necessary to happiness." In truth, there 
is nothing so remarkable throughout the Engadine as the 
peculiar stillness which meets the valetudinarian pilgrim 
in pursuit of health, who may here seek a brief respite from 
the cares and turmoil of civic life. This stillness, though 
more broken in the immediate vicinity of St Moritz by the 
stream of tourists who crowd thither each summer, is still 



ST MORITZ. 233 

even there sufficiently marked to contrast with any other spa 
on the continent. 

The village of St Moritz, consisting chiefly of half a dozen 
hotels and a score or so of lodging houses, needs no description. 
About a mile from the town are the mineral springs to which 
it owes its repute. The bath-establishment, or Kurhaus, is 
one of the largest in Switzerland, and is provided with all 
the usual resources of such places. The springs are powerful 
alkaline chalybeates, and, according to Dr Planta's analysis, 
the Alte-Quelle contains eleven grains of saline ingredients 
in a pint; whilst the Neu-Quelle contains thirteen grains, 
principally consisting of carbonate of lime, soda, magnesia 
and iron, and sulphate of soda, together with about forty cubic 
inches of carbonic acid gas. The class of cases in which a 
water of this kind should be used have been so fully pointed 
out in the chapters on other saline chalybeates, such as Spa and 
Schwalbad, that it is unnecessary to say more than, in addition 
to the ordinary anaemic, and chlorotic complaints in which 
they may be prescribed, St Moritz, on account of its 
climatic advantages, may be employed in cases of debility, 
nervous exhaustion, and premature decay, from over brain- 
work, pretubercular cachexia, especially in patients of scrofu- 
lous diathesis, and in other atonic non-inflammatory chronic 
disorders. 

Tarasp, in the Lower Engadine, may be reached by diligence 
in eleven hours from the Spa just described. The mineral 
sources of this comparatively modern, but now very important 
watering-place, approach in their composition somewhat to the 
springs we have spoken of in the chapter on the Bohemian 
" Bitter- wassers," than which, however, they are less saline or 
purgative, and at the same time are decidedly alkaline and 
chalybeate, and therefore more alterative and tonic in their 
action. According to Dr Yon Planta, each pint of the Groser- 



234 LEUK. 

quelle of Tarasp contains 39 grains of chloride of soda, 33 grains 
of carbonate of soda, 22 grains of sulphate of soda, 16 grains 
of carbonate of lime, 7 grains of carbonate of magnesia, and 
about a third of a grain of carbonate of the protoxide of iron, 
together with 32 cubic inches of carbonic acid gas. The princi- 
pal use made of the saline alkaline waters of Tarasp is in the 
treatment of chronic abdominal visceral congestions and enlarge- 
ments, especially of the spleen and liver, more particularly in 
obstructions of the portal circulation, suppressed haemorrhoids, 
intestinal worms, especially taenia, and also, according to Dr 
Constantine James,* in asthmatic affections. 

To the foregoing sketch of the principal Swiss watering-places, 
a few words must be added concerning Leukekbad, or Loeche- 
les-Bains in the Canton Valais. The most direct route to 
Leuk is that by railway via Berne as far as Thun, and thence 
by road through the Bernese Oberland, and across the Gemmi 
Pass. The road from Thun to Leuk, although traversing the 
most magnificent and wildest of all the Alpine passes, the 
Gemmi, can hardly be recommended to any nervous valetudi- 
narian, being in many places a mere ledge cut out of the face 
of the vertical rock which towers above, and from which the 
nervous traveller can scarcely look without some fear into an 
abyss of nearly 2000 feet, which lies immediately beneath the 
narrow shelf on which he stands. Leuk may, however, be now 
reached by an easier though less picturesque route, namely, 
via Geneva and Lausanne by railway to Sierre, from which 
station Leukerbad is only five or six hours drive. 

The position of this village of hotels, built nearly 5000 feet 
above the sea at the extremity of an Alpine cut cle sac, the 
valley of the Dala, surrounded on all sides by the almost 
vertical walls of rocky mountains which tower above it, and 
only protected by a strong dyke of masonry from the fall of 

* Dr Constantin James, " Guide Practique, Aux Eaux Minerales," p. 457. 



LEUK. 



235 



some avalanche, such as have thrice already destroyed this 
watering-place, renders the climate so intensely cold as to be 
absolutely uninhabitable, except from the end of May until 
September. The hotels, of which are eight or ten, are, however, 
crowded by French and Swiss invalid visitors during the season. 
The springs of Leuk, some twenty in number, are thermal 
saline waters, the principal mineral constituent of which is 
sulphate of lime. The chief of these, the Lorenzquelle, has a 
temperature of 124°; and the others v-ary from that to 90°. 
According to Pagenstcher the following is the 

Analysis of the Hauptauelle. 



Sulphate of lime, .... 


11-34 


Sulphate of magnesia, 


1-76 


Sulphate of soda, 


0-45 


Sulphate of strontia, . 


0-02 


Carbonate of lime, .... 


0-31 


Chloride of sodium, .... 


0-04 


Carbonate of potash, .... 


0-03 


Carbonate of magnesia, 


0'02 


Carbonate of protoxide of iron, 


024 



14-66 

The principal use made of the thermal sources of Leuk is 
in the feaths, whicn are here taken in common, and in which 
the patients, in full custivme cle bain, of course, remain for the 
greater part of the day amusing themselves exactly in the 
fashion which I have in my account of the Swiss Baden quoted 
from a writer of the sixteenth century. This prolonged im- 
mersion in the thermal mineral fluid is unquestionably capable 
of producing a powerful therapeutic effect in many chronic 
diseases, and is especially applicable in obstinate cutaneous 
affections, secondary and tertiary syphilis, and in chronic 
rheumatism or rheumatic gout, although in the latter com- 
plaints the coldness of the climate oftentimes undoes the good 
effected by the waters. 



236 AIX-LES-BAINS. 



CHAPTER XLIII. 



AIX-LES-BAINS. 



Of the French spas frequented by English valetudinarians 
the most attractive in situation is Aix-les-Bains, close to the 
Lake of Bourget, ten miles from Chambery, and within fifteen 
hours of Paris by railway via Macon. During the season 
from May until September, the population of this little town 
of 4000 inhabitants, is annually increased by some 10,000 
invalid visitors, and every available house is then converted 
into an hotel or lodging-house, yet so great is the demand 
that it oftentimes is, as I found, a matter of difficulty to 
obtain any accommodation whatever. 

The main feature of Aix-les-Bains is its thermal establish- 
ment, a handsome granite building on the hill, a little above 
the town, and supplied by the two mineral springs which 
have their sources within the mountains above it. The 
number of baths contained in the establishment is over three 
hundred, and includes every variety, from the simple reclining 
bath to the most complicated local douche, or "pulverised 
water bath." The piscines and vaporarium are especially 
deserving of notice. Nearly opposite, and behind the 
" Pension Chabet," are the ruins of the ancient Eoman baths, 
and the houses in this part of the town are for the most part 
built from the Eoman remains which abound on every side, 
and some of which — for instance, the handsome triumphal 
arch of Campanus — still exist in perfect preservation. 



AIX-LES-BAINS. 



237 



Foremost amongst the lions of Aix are the remarkable caves 
in the mountain behind the town. These, some years ago, 
were drained by the Government, and thus the supply of 
thermal water was greatly increased and rendered regular. 
They are entered by a narrow tunnel cut through the solid 
rock leading into a lofty circular chamber, with a vaulted 
dome, which the torches rendered visible, Thence we came 
into a series of other caverns, some similar to the last, others 
like vast Gothic churches, with pointed roofs, supported on 
limestone columns, and many others, in which the limestone, 
eaten away by the action of the hot sulphurous water, had 
assumed all kinds of fantastic shapes and resemblances. 
The exploration into the remoter caverns would be no easy 
task for an invalid or a lady, and should not be attempted 
by either. 

The springs of Aix-les-Bains belong to the class of warm 
sulphurous waters. There are two sources — one the sul- 
phurous, the other miscalled the Source d'Alun, which, how- 
ever, contain hardly any trace of alum, and is properly 
designated the Source de St Paul 

Analysis of the Aix-les-Bains Sources, according to Br Seegen. 



A Litre of Water contains (in French 
Grammes) 


Sulphurous 
Source. 


Alum Source. 


Carbonate of lime, 

Carbonate of iron, 

Chloride of calcium, 

Chloride of magnesium, . 

Sulphate of lime, .... 

Sulphate of magnesia, 

Sulphate of soda, .... 

Baregine or glairine, 

Total, ..... 
Temperature, .... 


Gramme. 
1-1803 

0-0387 

0-1548 
0-4257 
0-7353 
0-3483 
A trace. 


Gramme. 
1-2384 
0-0774 
0-4644 
0-1548 
0-6966 
0-2322 
0-2322 

A trace. 


2-8831 
115° (Fahr.) 


3-0960 
117° 



The alum water is that generally taken internally, though 
comparatively little internal use is made of the waters at Aix. 



238 MARLIOZ. 

It is in the baths, and especially in the douche baths, that 
their efficacy is most often proved. 

The diseases in which a visit to Aix are commonly 
recommended are — chronic rheumatism, especially when 
enlarging and disabling the joints; rheumatic gout; and 
above all in certain chronic skin diseases. The local douches 
are also applied with great benefit to diseases of the eye and 
ear, and the so-called " pulverised water," is used with ad- 
vantage in cases of clergyman's sore throat and in ozoena. 

Three-quarters of a mile from Aix-les-Bains, on the road 
to Chambery, is the spa of Marlioz, where a sale de inhala- 
tion, and pump-room, has been constructed within the last few 
years. This building contains a couple of rooms — one for 
gentlemen, the other for ladies, where the water is forced up 
and reduced into a fine spray, which is inhaled for various 
periods by the patients. 

Marlioz is a cold, strongly sulphurous spring, containing 
traces of iodine. Its action is stimulant, and it is employed 
internally, and also in local douches, as well as by inhalation. 
By the physicians of Aix it seems regarded as almost a 
specific in pulmonary diseases, especially chronic bronchitis. 



YICHY. ' 239 



CHAPTEE XLIV. 

VICHY AND THE MINERAL SPRINGS OF AUVERGNE. 

Vichy, which is the spa par excellence of France, is situated 
on the Allier, in the department of the same name, and 
within ten hours' drive of Paris, by the Lyons Bourbonnais 
railway. 

The town has a resident population of about 6000 inhabi- 
tants, and is divided into two distinct parts, viz., Vichy les 
Bains and Vichy la Ville, which are separated by the park. 
The former consists of two or three long, handsome streets of 
hotels and lodging-houses, and here almost all the visitors 
reside. Neither the modern nor the older part of Vichy present 
much deserving of special notice, excepting the mineral springs, 
the new Casino, and the thermal establishment. 

The environs are said by several writers to be flat and 
uninteresting, but this observation, which is evidently copied 
from a well-known guide-book, does not apply, except to 
some parts of the immediate vicinity of the town; for the 
neighbouring country, at a short distance from Vichy, presents 
some of the most beautiful scenery and most interesting 
excursions in Prance. 

The geological strata from which the springs arise are 
the tertiary limestone and coal formations, and under the 
rock the basin of mineral water is supposed to extend over an 
area of six miles. 



240 



VICHY. 



There are nine mineral springs in use in Vichy, which are 
alkaline, ferruginous, and highly charged with carbonic acid 
gas, and in all, minute traces of arsenic have been discovered. 
They are divided into cold and thermal, also into natural 
and artesian. The former are in general warmer and less 
gaseous than the latter, which contain most iron. In all the 
principal saline ingredient is bicarbonate of soda. 



Analysis of the principal Mineral Sources of Vichy (M. Mossier). 





© 


\a 




„. 


1 




Substances in One Pint 


9f 


c3 




'S. 







i 


of Water. 


•& 2 




-« a 










& 






"3 


15 ^ 




m 




j 


Carbonate of lime, . 


1-61 


1-70 


2-30 


2-45 


3-29 


\ Analysis 
1 imper- 
f feet. 


3-41 


Carbonate of mag- ) 
nesia, . . \ 


0-30 


0-30 


0-30 


0-27 


0-35 


0-41 


Carbonate of iron, . 


0-08 


0-15 




0-36 


0-35 


0-17 


Carbonate of soda, . 


34-61 


32-40 


36-30 


33-52 


42-70 


32-07 


28-56 


Sulphate of soda, . 


5-57 


6-91 


7-05 


6-27 


3-04 


5-46 


6-49 


Chloride of sodium, 
Total, 


3-15 


3-88 


2-64 


1-10 


0-47 


3-45 


7-31 


52-13 


45-34 


48-59 


43-37 


50-20 


40-98 


46- 5 



Under the gallery behind the thermal establishment are 
found four of the mineral springs. The principal of these is 
the Grande-Grille, so named from the iron railing that formerly 
surrounded it, the temperature of which is 108°. Its taste is 
rather disagreeable — saline, and somewhat ferruginous. It is 
employed internally and externally, and, as it keeps well, is 
largely exported. This source is principally used in gout, 
gastric complaints, dyspepsia, and affections of the liver. 

The " Source des Mesdames " is non-thermal, and is nearly 
identical in composition with the " Pints Lardy," containing a 
large proportion of salts of iron, with traces of arsenic. As its 
name imports, it is used in diseases peculiar to women, 
and especially in anaemia and chlorosis. 



VICHY. 241 

The " Celestins " and the " Puits Lardy " are situated at 
the extremity of the old town, on the right bank of the river. 
The latter is. the only one of the sources which does not 
belong to the company which now farms the wells of Vichy. 
They contain more carbonic acid than the other springs. 
According to Dr Barthez,* the most eminent authority on the 
subject, the " Puits Lardy" contain also a large proportion of 
sulphuretted hydrogen gas, and being, therefore, the most 
stimulant of the Vichy waters, cannot be used with safety 
by those suffering from diseases attended by inflammatory or 
haemorrhagic symptoms, being principally employed in renal 
or vesical complaints, and in anaemic cases. 

The Vichy waters are alkaline, aperient, and alterative. 
Their principal use is in the treatment of gout, and in chronic 
diseases of the stomach, or abdominal viscera, such as dys- 
pepsia, chronic hepatic disease, biliary caleuli, fatty degene- 
ration, or cirrhosis, and in haemorrhoidal affections, which 
are so often connected with congestion of the liver. They 
are equally serviceable in enlargements of the spleen, and 
in many cases of hypochondriasis. Moreover, this spa is 
specially adapted for the cure of some of the chronic 
diseases of women connected with disordered menstruation, 
and for the anomalous " critical complaints " which often set 
in at the period of life when this function ceases. It is 
also much prescribed by French physicians in cases of 
diabetes, and in some instances may be thus used with great 
benefit. 

The complaint for which nine-tenths of the English visitors 
drink these springs is gout, and I believe that the dis- 
appointment which so often drives gouty patients home 
again to patience and flannel, is the result of the misconceived 
ideas which prevail on this subject. It should be distinctly 

* "Guide Pratique Aux Eaux de Yichy," par le Dr F. Barthez, 7th ed., p. 94. 

Q 



242 VICHY AND CUSSET. 

understood that Vichy water is not a specific for the gout. It 
can only act on the gouty diathesis, by improving the tone of 
the digestive organs, augmenting the secretions, and correct- 
ing the abnormally acid condition of the blood in such cases. 
Gouty patients whose disease springs from dietetic errors and 
neglect of exercise, come to Vichy ; their appetite is increased 
by the change of air and foreign cookery ; they indulge that 
fictitious appetite fully at the table d'hote, and then return 
home wondering why they ever went so far for so little good. 
The remedies for gout are abstemiousness and exercise. 
Vichy water may aid, and aid materially, but it cannot 
supersede these. 

Two miles from Vichy is the town of CUSSET, the antiquity 
of which is evinced by its narrow winding streets, quaint old 
houses, and handsomely-wooded boulevards. Entering it, 
we passed a large tower, now used as a prison, whose walls, 
twenty feet thick, resisted many a fierce attack from the 
lords of Auvergne and Bourbonnais in the troublous days 
of Louis XI. Now, however, Cusset is an unimportant 
market town, remarkable only for its mineral waters, which 
seem to have attracted less attention than they deserve. 

These springs belong to the same class as those of Vichy, 
than which they are, however, stronger, containing more car- 
bonic acid gas, bicarbonate of soda, and iron. The "Elizabeth" 
well, for instance, is said by its proprietors to contain six 
times as much soda as any of the Vichy springs. The " St 
Marie" is also very rich in the same salts. It supplies the 
bath-house, a handsome building with reading saloons, pump- 
rooms, and about thirty very neat and well-constructed 
douche and reclining baths. 

The waters of Cusset, which are all cold, are used in the 
same class of cases as those of Vichy, but being stronger, 
require still more caution in their administration. 



MONT-DORE. 243 

In the same ancient province of Auvergne, though not 
in the same department, there are some other mineral 
springs, less known than Vichy to Engish valetudinarians, 
but esteemed of considerable remedial power by French 
physicians and their patients. For the materials of the 
following brief notice of these spas I am indebted to my 
father, Dr E. E. Madden, who has visited them since I have 
been in Auvergne. 

The spas to which I would now invite attention are the 
thermal waters of Mont-Dore, St Nectaire, and Eoyat. The 
first of these, Mont-Dore, may be reached from Vichy by 
railway to Clermont, and thence by coach. It lies about 
thirty miles from Clermont, in a small valley 3500 feet above 
the sea, and immediately under the Pic du Sancy, the highest 
mountain in central France. Between Clermont and Mont- 
Dore the road which passes the remarkable mountain of the 
Puy de Dome crosses the most singular, and to a geologist 
most interesting, volcanic district in Europe ; on every side 
may be seen extinct craters, masses of the scoriae and 
lava ejected from these, and vast blocks of basaltic rock, 
evidently of volcanic nature, all of which attest that this 
region was at one time the scene of convulsive igneous action 
of incalculable force and activity, 

Mont-Dore-Les-Bains, although said to be one of the most 
ancient watering-places in Europe, is now but a village, con- 
taining several good hotels. There are eight mineral sources 
here, the temperature of which vary from 115° to 59°. The 
chief chemical ingredients in all are bicarbonate of potash, 
carbonate of lime, and sulphate of soda. Besides these, recent 
chemists have proved that the waters contain rather more 
than one millegramme of arsenite of soda in each litre. 

The cases in which the baths and waters of Mont-Dore are 
prescribed are certain forms of chronic bronchitis, asthma, and 



244 ST NECTAIRE AND ROYAT. 

laryngeal complaints, gastroenteric, and uterine disorders 
marked by congestion, similar cases in which the liver is 
implicated, nervous maladies, such as neuralgia and sciatica, 
and scrofulous diseases, especially of children. 

About fifteen miles from Mont-Dore, near Murol, is the 
watering-place of St Nectaire, also in a volcanic district. 
There are seven thermal springs in this locality, the tempera- 
ture of which varies between 75° and 110°. They are all 
alkaline, ferruginous, and stimulant. They are principally 
used in cases of renal and hepatic disease, in enlargements 
of the liver, or spleen ; and are also employed in amenorrhea, 
leucorrhcea, and gout. 

The last of the spas of central France to which I shall allude 
is Eoyat, situated eight miles from Clermont. The waters 
of Eoyat closely resemble those of Mont-Dore, than which 
they are, however, one-third stronger. Eoyat is in consider- 
able repute with many French physicians in the treatment of 
scrofula, gout, and rheumatism. 



THE SPAS OF THE PYRENEES. 245 



CHAPTER XLV. 

THE SPAS OF THE PYRENEES — CAUTERETS, 

In no part of Europe will the valetudinarian find so wide a 
choice of mineral and thermal springs to select from, within 
the same extent of country, as in the Pyrenees, where some 
two hundred of these fountains of health have been dis- 
covered. 

The mineral waters of the Pyrenees may be divided into 
three classes, viz. : — Sulphurous, Saline, and Ferruginous, 
and two-thirds of them belong to the first-named class, of 
which Cauterets, Bareges, Bagneres-de-Luchon, and Saint 
Sauveur are examples. The saline waters are illustrated by 
Bagneres-de-Bigorre and Dax ; and the ferruginous by Castera- 
Verduzan and Casteljaloux. 

The attractions of the Pyrenees are not, however, confined 
to the invalid traveller, but even for the pleasure tourist offer 
inducements for a pedestrian excursion in some respects 
superior to any in Switzerland. And for a man in health, 
what mode of travel affords hereafter such pabulum for 
memory, such a variety of incidents, and such pleasant 
recollections, as a pedestrian journey with a genial companion, 
and in fair weather, through so beautiful a country as the 
High Pyrenees. He who would attempt this, however, must 
be prepared to "rough it;" to endure fatigue, occasional 
inclemency of weather, meagre diet, and indifferent lodging, if 
he would go beyond the mere beaten track of tourists ; and to 



246 BAGNERES-DE-BIGORRE. 

dispense for the time with the luxuries, contenting himself 
with the necessaries of life. 

It is strange how soon one gets accustomed to the hardships 
of this mode of life. Thus, for instance, although previously 
unused to pedestrianism, within a few days after I commenced 
this walking tour, I found myself so braced up by the pure 
mountain atmosphere, that I could walk without any material 
inconvenience from early morning until evening. 

Such a programme may not look inviting, but this I know, 
that if the object of an autumn tour abroad be the improve- 
ment of health impaired by attention to some absorbing 
pursuit, and a sedentary civic life, a pedestrian journey of this 
kind will do the traveller more physical, as well as moral 
good, than would the same time spent in almost any other 
way. And even for valetudinarians who are unable or un- 
willing to encounter hardships and fatigue, the Pyrenees 
offer resources. The railroad from Bordeaux now runs to 
the very centre of these mountains, and every spa is within an 
easy drive from the train. 

Our pedestrian journey through the Pyrenean watering- 
places commenced at Tarbes, ten kilometers from which the 
ascent of the mountains begins. After a brief pause in the 
hamlet of Mont-Gaillard, where the hostess of the village inn 
prepared an omelet worthy of the Maison Doree, leaving the 
tilled plain behind, we entered into a hilly pasture country, 
not less populous than the lowlands, and at nightfall arrived 
at Bagneres. 

Bagneres-de-Bigorre is an ancient town of 9000 inhabi- 
tants, situated at the foot of the mountains, between the 
valleys of Tarbes and Campan ; and may now be reached from 
Paris by railway, via Bordeaux, in thirty-six hours. 

The aspect of Bagneres-de-Bigorre is very Spanish. The 
promenade is more like an Andalusian "Alameda" than a 



BAGNEKES-DE-BIGORRE. 247 

French Boulevard ; and the narrow winding streets, the 
projecting roofs of the houses, and the dress of the peasantry, 
all reminded me of a Spanish scene. The bath-houses and 
thermal establishment are large, handsome buildings, and the 
hotels are numerous and good. 

There are a considerable number of mineral springs in 
Bagneres-de-Bigorre belonging to the class of saline sul- 
phurous waters; the town being probably built over a 
subterranean thermal stream, which issues forth wherever 
an opening is made; and consequently the several wells 
differ only accidentally, according to the strata they may 
pass through between this subterraneous river and the sur- 
face. Besides the sulphate of lime which is characteristic 
of all these sources, with few exceptions, they contain more or 
less carbonate of iron; and act as stimulating sulphurous 
saline chalybeates. Accordingly they are indicated in the 
treatment of anaemic and chlorotic cases ; in chronic mucous 
discharges from either the urinary or the pulmonary organs, 
when unaccompanied by any inflammatory action ; in haemor- 
rhoids ; habitual constipation ; dyspepsia and loss of appetite, 
and in some forms of enlargement of the liver and spleen. 

The waters of " La Beine," and of " Lasserre," in doses of 
from five to six glasses, "are considered as mildly laxative, 
as well as stimulant. The less strongly mineralised sources 
— " Le Source Foulon," " Petit Bareges," " Salut " — are said to 
produce a somewhat sedative action on the nervous system. 

Having remained some days in Bagneres we resumed 
our journey to Cauterets, visiting on our way Lourdes, now 
the most famous shrine in Europe. On leaving Lourdes, 
which we did at a very early hour, we pursued our way by a 
road not unlike that which those who have crossed the Irish 
Channel will remember as the Scalp, near Dublin, with 
mountains on all sides, whose loose rocks seem ready to fall 



248 CAUTEKETS. 

on the traveller below. Emerging from this desolate region we 
passed through the plain of Argalez, the loveliest valley of the 
Pyrenees; and making a brief halt at the village of Pier- 
refitte, which closes this vale, and where two gorges open in 
the mountains, one on the left leading to Bareges, and the 
other on the right to Cauterets, arrived at our destination 
after a walk of ten hours. 

Cauterets is situated some 3000 feet above the level of the 
sea, in a deep cut de sac, formed by snow-covered mountains, 
the only road through which, beyond the village, being by 
the foot paths which lead into the recesses of the Pyrenees, 
or into Spain. The houses of Cauterets form a long narrow 
street divided by an irregular square containing the " Hotel de 
Paris" and some others, whence a shorter street leads up 
the side of the mountain to the thermal establishment, which 
is fitted up with every modern improvement in the baths, 
and is supplied from the distant mineral sources on the hill, 
in the same way as the waters of PfefTers are brought to 
Eagatz. 

The railway via Bagneres-de-Bigorre, has now placed this 
watering-place within a couple of days' journey from Paris. 
Moreover, the beauty of the surrounding scenery, and the 
excursions which may be made from hence through the 
High Pyrenees and into Spain, especially that by the " Pont 
d'Espagne" to the wild and romantic Lac de Gaube, attract 
many visitors to Cauterets, who have no need of its mineral 
springs. 

Cauterets possesses twelve thermal sources, which are 
scattered about the village, and some are at a considerable 
distance from it. For convenience of description they are 
divided into two groups, viz. : — Les Sources de VEst and Les 
Sources du Midi. They differ in temperature from 131° to 86° 
and present some variety of composition, though they all 






CAUTERETS. 249 

agree in being rich in sulphuretted hydrogen gas, in silica, 
and in glairine, and in the rapidity with which the sulphates 
they contain are decomposed and changed into sulphites or 
hyposulphites. 

La Kaillere, the most celebrated of the mineral springs of 
Cauterets, is about half an hour's walk from the town, on the 
road to the Lac de Gaube. The water is clear, and its 
temperature is 102° ; it is saponaceous to the touch, with a 
slightly sulphurous smell, and sweetish, mawkish taste. It is 
conducted into a commodious bath-house, the douches in 
which are particularly well constructed. This spring is used 
in chronic catarrhal affections of the respiratory organs, and in 
incipient phthisis. I do not myself, however, agree with 
those who prescribe this remedy in the latter disease. 

The sources of " Cesar " and " Les Espagnols," which supply 
the grand bath-house, are the most stimulating waters of 
Cauterets. Internally, they are used in chronic catarrh, and 
in some forms of asthma, and, as baths, they are ordered in 
cases of chronic rheumatism, certain skin diseases, and 
scrofulous affections. 

" Les deux Pauces " are similar in action, but milder than 
the last-described springs. The " Petit St Sauveur " is still 
more soothing, and is chiefly used for baths and douches, in 
leucorrhcea and some uterine diseases, as well as in certain 
nervous affections. " Le-Pre " is administered in chronic 
rheumatism; and so also are the sources of "Mahourat" and 
" Le Bois," which are nearly a mile from the town. 



250 BAREGES. 



CHAPTEE XLVI. 

THE PYRENEAN WATERING-PLACES CONTINUED. 

From Cauterets we returned to Pierrefitte, whence the road to 
Lux and Bareges branches off to the left, and after a steep 
ascent of four miles enters the dark and cheerless valley of 
the Bastan, in which the spa we are about to describe is 
situated. 

Bareges is a small village, consisting of one long street, of 
about a hundred houses, built of stone, standing immediately 
over a mountain torrent, the Grave of the Bastan, and is as 
wild and desolate a place as can well be imagined. 

Being the most elevated watering-place in Europe, the 
climate, even in summer, is cold and variable, and in winter it 
is such as to render the village uninhabitable. None but 
those who absolutely require the waters are to be met with 
in Bareges, for nothing else could, I think, induce any one to 
pass a single week in this village. And yet, however, between 
6000 and 7000 invalids reside here during the short season. 
Great, therefore, must be the medical virtues of the springs, 
which can thus attract the votaries of fashion and of pleasure 
to so remote, inaccessible, and dreary an abode as this. 

There are nine mineral sources in Bareges, the tempera- 
ture of which vary from 86° to 112°. Eight of these are 
contained within the bathing establishment, in the centre of 
the town. They are perfectly clear, have a strong sulphurous 
taste, and well-marked "hepatic" odour. They are more 



BAREGES. 251 

fixed, and change less by keeping than the other Pyrenean 
sulphurous waters, and they all contain a considerable amount 
of the peculiar, pseudo-organic, unctuous substance called 
" Baregine." 

The saline matters found in the nine sources of Bareges 
principally consist of the sulphates of soda and lime, silicates 
of the same salts, chloride of sodium, with traces of oxide 
of iron and iodine.* 

The primary action of the Bareges spa is stimulant and 
tonic, producing considerable nervous and vascular excite- 
ment ; accordingly, it is best suited for persons of lym- 
phatic or scrofulous diathesis, and it should be especially 
avoided by those of a plethoric habit of body, by pulmonary 
invalids, as well as by valetudinarians suffering from any 
lraemorrhagic or congestive disease. 

In the form of baths, these waters are applicable in the 
treatment of cases of old wounds, either breaking out afresh 
or causing recurring pain, in carious disease of the bones, in 
articular complaints, whether rheumatic or resulting from 
injury. They are largely used in obstinate skin diseases, 
more especially when of secondary, or of mercurial origin; 
also in chronic rheumatism and scrofulous affections. The 
duration of the course must be regulated by the effect it pro- 
duces. The full time is six weeks ; but in many cases half 
that period might be dangerous to the patient's life. 

About a mile from Lux is a spa in every respect different 
from that which has been last described, viz., St Sauveue. 
The situation of this village, at the entrance of the plain of 
Gavarnie, within reach of the most sublime scenery in France, 
i.e., the Breche de Eoland, Mont Perdu, and the Vignemale, is 
most attractive. The watering-place itself is a mere hamlet 
connected with Lux by an avenue of poplars. There are a 

* MM. Petrequin et Socquet, " Traite General des Eaux Minerales," p. 413. 



252 SAINT SAUVEUR AND BAGNERES-DE-LUCHON. 

couple of good inns, besides which the accommodation of the 
lodging-houses is comfortable, the charges are moderate, and 
the thermal establishment is very complete. 

There is but one mineral source in St Sauveur, although 
there are four or five outlets from this, which some writers 
mistake for distinct springs, and describe as such. 

The water is saline and alkaline. It is perfectly limpid, is 
warm, 95°, and has a soapy or unctuous taste, caused by the 
amount of glairine suspended in it. 

The waters of St Sauveur are used as baths, injections, and 
for drinking. Their medicinal action seems due to their 
temperature, the amount of nitrogen and glairine they con- 
tain, and their alkalinity. In their influence on disease they 
somewhat resemble the springs of Wildbad, and exert a 
peculiarly sedative influence on persons of a nervous and 
irritable temperament. They are prescribed in hysterical cases, 
in dyspepsia, in vesical catarrh, in chronic ovarian or uterine 
affections, and leucorrhoea, and in neuralgia and sciatica. 

The next of the Pyrenean spas, in the order of their posi- 
tion, is Bagneres-de-Luchon, which lies close to the Spanish 
frontier, and may now be reached in about forty hours from 
Paris by the railway to Bagneres-de-Bigorre, and thence by 
diligence. 

The accommodation for invalid visitors at Luchon is better 
than at most of the Pyrenean spas, there are nine or ten very 
tolerable hotels, and a fair choice of apartments. Living is 
comparatively cheap and good, game being abundant, and the 
fish from the mountain streams is excellent. Not only are 
the comforts, but the luxuries of civilised life, such as balls, 
concerts, clubs, &c, attainable in Luchon, and in this respect 
it comes nearer to the German watering-places than the other 
Pyrenean health resorts. 

There are about thirty distinct mineral springs in Luchon, 



AMELIE-LES-BAINS. 253 

the temperature of which varies from 150° to 60°. These 
are all sulphurous and saline; their principal saline con- 
tents being sulphate and hyposulphate of soda, with silicate 
of soda. 

The water is used principally for bathing, but is also taken 
internally, in doses of from two to three small glasses, either 
pure or with an equal part of milk. The diseases in which 
Luchon is resorted to are — cutaneous affections, indolent 
ulcers, chronic rheumatism, arthritis, and caries. It is also 
strongly recommended in many cases of scrofulous enlarge- 
ments, hypochondriasis, and dyspepsia. 

Amelie-les-Bains, in the department of the Eastern 
Pyrenees, on the route from Perpignan to Barcelona, is now 
one of the most rising health resorts in the south of France, 
being frequented by valetudinarians not only in summer on 
account of its mineral waters, but also in winter by pul- 
monary invalids, though in the latter case, in my opinion, 
often with questionable judgment, on account of the mild- 
ness of the climate. 

The village, which contains about 800 inhabitants, is built 
in semi-circular form, at the foot of a hill on the right bank of 
the river Tech, two miles from Aries. The mineral waters 
of Amelie issue from numerous sources, which are all warm, 
sulphurous, and very gaseous. There are three separate 
thermal establishments, principally resorted to in the treat- 
ment of chronic rheumatism, skin diseases, neuralgia and 
sciatica, in affections of the kidneys and urinary organs, 
leucorrhcea and irregularities of the catamenia. Amelie is 
also frequented by scrofulous patients, and is said to be pro- 
ductive of great benefit in glandular and articular diseases of 
this class. It is, moreover, though I believe with much less 
utility, prescribed in chronic laryngeal and bronchial com- 
plaints, and in dyspepsia. 



254 THE PYRENEAN WATERING-PLACES. 

It would be out of keeping with the plan of this work for 
me to attempt any detailed account of my walking tour 
through the remaining Pyrenean spas. But I would how- 
ever strongly recommend such a tour to the imitation of any 
traveller for health who has sufficient youth and strength to 
endure some hardships, such, for instance, as a day's walk from 
Arruns across the Col de Torte, which our landlord had in vain 
attempted to dissuade us from crossing, as he said a storm 
was impending ; but mistrusting the disinterestedness of his 
suggestion, we started. The first persons we encountered after 
an hour's walk, when we were ascending the mountain, were 
a couple of herds driving their sheep into the valley, who 
repeated the same ill-bodings, and advised us to return to 
Arruns, as the path over the Col was covered with snow. 
However, as it looked clear and bright we pursued our way, 
and only when it was too late to turn back we found our 
error. For, after a long, toilsome ascent, when we had crossed 
the first Col, and were passing the narrow footpath which 
overhangs the deep ravine under the Pic de Gabiscos, a 
hurricane suddenly arose, drifting snow and sleet, and large 
stones, were hurled along as dust ; we were forced back by 
the irresistible power of the wind ; it was even impossible for 
us to stand, and it was only by throwing ourselves prostrate 
that we escaped being blown over the precipice. The wind 
came rushing down in squalls every few minutes, and between 
each of these violent gusts we had only time to advance a few 
perches before we were again forced down. At length, when 
nearly exhausted, we fortunately reached a wooden shed 
where we sheltered until the violence of the storm had abated, 
and crossing the Col de Torte, over which the path was undis- 
tinguishable under the accumulated snow, finally, after a walk 
of twelve hours, arrived at Eaux-Bonnes. 

Eaux Bonnes is a small village in the Basses-Pyrenees in 



EAUX BONNES. 255 

the valley of Ossau, about twenty- five miles from Pau. Its 
situation, in a deep ravine enclosed by lofty mountains, is 
highly picturesque. These mountains approach so close to 
the village that they have been quarried in every direction to 
make way for the modern extension of the place. 

The three principal mineral sources, which are found at the 
foot of Mount Tresor, are " La Vieille " (ou la Buvette), the 
temperature of which is 92° ; " La Nouvelle," temperature 
88°; and "La Source d'Eau has," temperature 90°. Besides 
these there are two other springs immediately outside the 
village ; one of these wells, which is cold, is the only source 
here used internally. 

The Eaux Bonnes are all very gaseous, and have a sul- 
phurous smell and unctuous taste. They belong to the class 
of alkaline sulphurous spas ; but are not so alkaline, and 
contain less silica and more sulphate of lime than other 
Pyrenean waters of the same class. 

In their action Eaux Bonnes are stimulant, though less 
exciting than some of the Pyrenean sulphurous spas. They 
require, however, to be used with great caution in small doses, 
commencing with a quarter of a tumblerful, which may be 
gradually increased, if it produces no ill symptoms, to two 
small glassfuls a day. 

The season lasts from May to the beginning of September. 

Formerly the principal use of the waters of Bonnes was 
externally in baths, in the treatment of old and painful 
wounds, and ulcers. Thus their ancient name of "Arque- 
busades," was derived from the wounded musketeers, who, 
after the battle of Pavia, were brought hither by Jean 
d'Albret, to be cured. Now, however, the chief employment 
of these springs is internally in the treatment of chronic 
pulmonary affections, among which is included phthisis. My 
own opinion of the inemcacy of mineral waters in the treat- 



256 EAUX-CHAUDES. 

ment of consumption has been expressed so often in the pre- 
ceding pages that I need not here repeat it. 

The Eaux Bonnes are most useful in chronic maladies 
of the abdominal viscera, in hypochondriasis and hysteria, in 
obstinate intermittent fevers, in chronic catarrhal affections, 
and, as baths, in the treatment of chronic ulcers, fistula, and 
caries. 

Eaux-Chaudes, in the Low Pyrenees, is situated in a wild 
and sombre mountain gorge on the right bank of the Gave, 
four miles from Eaux Bonnes. 

The approach to Eaux-Chaudes, through this dark ravine, 
is calculated to depress a nervous patient, and the aspect 
of the village itself, consisting of a few straggling houses, 
which stand on a narrow ledge between the mountains 
and the Gave, is far from cheerful. But still, though present- 
ing nothing but its waters to attract visitors, Eaux Chaudes is 
frequented by a considerable number of invalid residents each 
season. There are four or five good hotels, and the expenses 
of living are moderate. 

There are six mineral springs at this spa, all of which issue 
at the junction of the granite and limestone formations at 
the foot of the mountain, which divides the valley of Eaux 
Bonnes from that of Eaux-Chaudes. 

The thermal establishment is supplied by three sources — 
which are all used both internally and as baths. Notwith- 
standing its name, none of the springs of Eaux-Chaudes have 
an elevated temperature. Thus, the temperature of "Le 
Clot," the warmest of these, is 97°; and one, namely, the 
Source Mainvielle, is quite cold. They are all but slightly 
mineralised, though rich in " glairine " and sulphuretted 
hydrogen gas. The principal saline contents of the waters 
are chloride of sodium, sulphate of lime, silicate of lime, 
sulphate of soda, and carbonate of soda. 



PAU. 257 

The Eaux Chaudes are very stimulating, acting with equal 
energy on the nervous and circulating systems; and are 
principally used in the treatment of obstinate skin diseases, 
scrofulous swellings, and articular enlargements, in chlorosis 
and amenorrhea, as well as in chronic rheumatism, sciatica, 
and neuralgia. 

All the Eaux-Chaudes, especially the warmer and more 
stimulating sources, require the utmost caution in their use, 
and none of them can he employed in safety excepting in 
accordance with the advice of a resident physician. 

Here ended my walking tour through the Pyrenees. From 
Laruns I drove to Pau, and renewed my acquaintance with 
the ancient capital of Beam. 

The mineral spring of Pau is situated immediately without 
the town, between the park and the river. This source has not 
been many years in use, possesses a slight chalybeate taste, 
is cold and limpid, and leaves a ferruginous tinge in the 
stone basin into which it is received. Its use, which is very 
limited, need not be here dwelt on, as it differs in no wise 
from what I have already spoken of, in the introduction, as 
the general action of all simple chalybeate mineral waters. 

Having rested ourselves after our long pedestrian journey 
through the mountains, by a short stay in Pau, we turned 
our thoughts homewards, and leaving Pau by train in the 
afternoon, arrived the same evening in Dax. 



253 dax. 



CHAPTEE XLYIL 

DAX, PASSY, AUTEUIL, ENGHIEN, PLOMBIEKES, AND CONTREXVILLE. 

The very ancient town of Dax on the Adour, since the com- 
pletion of the railway from Bordeaux to Pau, is seldom visited 
by tourists. So far back as the tenth century, the fountain of 
"Nelse" was frequented by patients from every part of 
Europe ; but now, excepting the inhabitants of the depart- 
ment, hardly a single invalid is attracted to Dax by its 
thermal springs. The most important of these is contained 
within a large roofless structure of considerable antiquity, 
which encloses a reservoir of hot mineral water some seventy 
feet in length by fifty in width. The water is clear, and its 
temperature in the basin is 125°, whilst in the spring which 
supplies this, it rises to 156°. 

The scene around the front of the basin when we first 
visited it in the early morning was very curious. The whole 
population of Dax were apparently assembled in the little 
square — every man, woman, and child with a large, peculiarly- 
shaped tin vessel, strapped over their shoulders, and each 
patiently awaited their turn to fill these at one of the spouts 
by which the warm water issues from the basin. I remarked 
that before doing so, however, it seemed the rule to take a 
deep draught of the thermal fluid. This supplies most of 
the domestic and culinary purposes of the people of Dax, to 
whom it saves no small expense for fuel. 

Besides this there are two other warm springs — " La 



passy. 259 

Source des Fosses," and " Les Bagnots ; " used extensively 
for bathing. 

The mineral springs of Dax, which are almost unknown in 
this country, are mild, saline, thermal waters, their chief 
chemical ingredients being the sulphates of lime and soda, 
with a little common salt, and carbonate of magnesia. They 
are commonly used, with the happiest result, by the in- 
habitants of the Landes, in cases of chronic rheumatism, and 
rheumatic-arthritis, causing impairment of the joints ; and in 
contraction of the muscles, following recovery from severe 
surgical disease. They were prescribed by the French 
physicians of the last century, in certain forms of paralysis, 
and also in pulmonary affections, especially asthma, but are 
no longer employed in these cases. 

"Within the recently extended limits of Paris, at Passy, 
there exists a very strong chalybeate water — so strong that 
before it is used internally, it is necessary to allow it to stand 
exposed to the air for some time, until it deposits a fer- 
ruginous sediment which falls rapidly, being only suspended, 
not dissolved, owing to the want of sufficient carbonic acid 
gas. There are four sources, whose chemical composition 
is nearly identical. The chief mineral constituents of all 
these are, sulphates of iron, lime, magnesia, and soda. The 
Passy waters are used externally in the treatment of chronic 
ulcers, and in cases of leucorrhcea. They are also prescribed 
internally, with the precaution of allowing the water to 
deposit the suspended salts as I have just described, in doses 
of from one to three small glassfuls, in cases of general and 
local anaemia, chlorosis, fluor albus, some intermittent febrile 
disorders, atonic dyspepsia, and diarrhoea, and, in a word, in 
all those diseases connected with poverty of blood, in which 
ferruginous tonics of this class are indicated. 

In the neighbouring suburb of Auteuil a somewhat similar 



260 AUTEUIL AND ENGHIEN. 

mineral water exists. This spring is known as the " source de 
Quicherat," and from the sixteenth century to the present time 
has been resorted to by the Parisian bourgeois in the same 
class of cases as the wells of Passy are employed in. 

The last of the watering-places in the neighbourhood of 
Paris which I visited was Enghien-les-Bains, which is within 
twenty-five minutes' drive of the city by either the Nord or 
Ouest railways. This spa overlooks the valley of Mont- 
morency and is prettily situated on a small lake surrounded 
with fantastic villas, many of which are said to belong to 
persons of the Parisian demi monde. 

Enghien possesses a large thermal establishment, open all 
the year round. This building faces the lake, and contains 
about a hundred bath-rooms, besides excellent accommodation 
for invalid boarders. 

The mineral springs of Enghien are cold, sulphurous waters, 
containing a large volume of sulphuretted hydrogen gas, and 
a considerable amount of sulphate of lime. 

Of these sources only two, viz., "Du Eoi " and "Deyeux," 
are used for drinking, the others being too strong for that 
purpose. The Enghien waters are powerful stimulants. In 
small doses, conjoined with the baths, they increase the 
appetite, quicken the pulse, and excite a determination of 
blood to the skin. If taken for some days without intermis- 
sion, or if the dose be at all too large, they occasion " spa 
fever," sometimes of a most dangerous type. 

It appeared to me, when at Enghien, that these springs are 
used in a very incautious manner; and in every class of 
chronic disease without discrimination. I have already 
shown that strong mineral waters, like all remedies of any 
value, are two-edged weapons, not less powerful for evil 
than for good, and those of Enghien are certainly no 
exception to this rule, and should never be drunk, as they 



PLOMBIERES. 261 

appear to be by some, without judicious medical advice, nor 
in larger doses than half a tumblerful each morning, nor 
should the patient take the baths every day, or remain 
many minutes in them. Both the baths and the internal 
use of the waters should be discontinued if they produce the 
least febrile irritation, headache, or cerebral excitement ; and 
the patient should not allow himself to be influenced by the 
advice of the managers of the thermal establishment, if it be 
in opposition to these plain rules. 

The Enghien spa, like other sulphurous waters, is employed, 
and sometimes very efficaciously, in the treatment of various 
skin diseases, scrofulous affections, certain mucous discharges, 
chronic glandular and articular enlargements, in some " second- 
ary and tertiary symptoms," as well as in rheumatic affections. 

A few words on two watering-places in the Vosges Moun- 
tains will conclude my account of the French spas. The first 
of these is Plombiekes, which is twenty-five miles from Epinal, 
and may be reached in thirteen hours from Paris by the 
Chemin de Fer de l'Est. The situation of this town, in a deep 
ravine surrounded by lofty mountains, renders the climate 
cold and variable. But despite this, these mineral waters, 
having been used by Napoleon the Third, are particularly in 
vogue with the adherents of the late regime. The place 
itself is one of the most frequented of the French health 
resorts, having excellent hotel accommodation, as well as a 
magnificent bathing establishment. 

There are upwards of twenty mineral sources in Plombieres ; 
of these fifteen are thermal. Of the non-thermal springs one 
is chalybeate, and two are what French writers term " sources 
savonneuses." The general character of all these is a very 
weak alkaline mineralisation, and their chief employment is 
in douche and other baths; only two, viz., "La source du 
Crucifix " and " La source des Dames," being used internally. 



262 CONTEEXEVILLE. 

The waters of Plombieres, as Dr Edwin Lee pointed out 
many years ago, in their chemical properties and therapeutic 
effect, resemble those of Teplitz, and are not only strongly 
diuretic in their effects, bat also act as special stimulants on 
the uterine system; and hence are prescribed in cases in 
which it is desirable to increase the renal secretion, as well as 
in the treatment of chronic affections of the uterus and its 
appendages, dysmenorrhea and uterine catarrh. 

In the same department as the last place is another locality 
which, though long known to contain powerful mineral springs, 
has only comparatively recently become a fashionable water- 
ing-place, and seems to be in especial favour with American 
valetudinarians. Conteexeville may be reached in about 
twelve hours by the eastern railway from Paris to Neuf chateau, 
and thence by coach in three hours. 

There are three distinct mineral sources in Contrexeville, the 
most important of which is " La Source du Pavilion," but all 
are sufficiently similar to be described together. These belong 
to the same class, and are employed in similar cases to Leuk 
and Pisa, being what I have described as earthy springs, the 
chief saline ingredient of which is sulphate of lime. Besides 
this they also contain a small quantity of sulphates and 
chlorides of soda, potash, and magnesia, together with traces 
of iodine, strontium, and arsenic, the latter in imponderable 
quantities. 



THE SPAS OF ITALY. 263, 



CHAPTEE XLVIII. 

THE SPAS OF ITALY. 

Few countries are so rich in mineral and thermal springs as 
Italy. Almost all the Italian spas are situated in the valleys 
at the foot of the mountain chains which intersect that 
country. Many years since, Dr G-airdner remarked that, u in 
the prolongation, southwards of the Italian peninsula, all its 
mineral waters are met with on the Mediterranean side of the 
Apennines, and none on the Adriatic."* The explanation of 
this curious fact is to be found, as I have shown in the intro- 
ductory chapter on mineral and thermal springs, in the position 
of the volcanoes, and other evidences of subterranean igneous 
action in that part of Italy. 

Commencing our tour through the Italian watering-places 
in Lombardy, the first of these spas that we meet with is 
Acqui, a very ancient town of 9000 inhabitants, in a moun- 
tainous district, about thirty miles from Genoa, and a drive 
of an hour and a half by railway from Alessandria. The 
mineral springs originate in limestone rock, and are divided 
into cold and thermal sources. They are mildly sulphurous ; 
but are so slightly charged with chemical ingredients, that, 
diluted with half their quantity of ordinary water, they are 
employed by the housewives of Acqui for all domestic and 
culinary purposes. The warmest source in the town has 

* " Essay on Mineral and Thermal Springs," by Meredith Gairdner, M.D., 
p. 141. 



264 ACQUI AND ABANO. 

a temperature of 124° ; is slightly sulphurous and saline, and 
is perfectly clear and limpid. 

Acqui is seldom resorted to as a sulphurous spa, being 
inferior in chemical strength to most waters of that class. 
But the mud-baths of Acqui are remedies of considerable 
power. The "humus," or mineralised mud, is collected in 
small chambers, into which the patient enters, and lying 
down, is completely, with the exception of his head, covered 
with a thick layer of the " humus," as hot as he can bear it, 
and remains thus immersed for about three-quarters of an 
hour, immediately after which a warm bath of the mineral 
water is administered. 

The first effect of the sulphurous mud-bath is to excite a 
strong determination of blood to the surface, followed by a 
profuse perspiration, which renders it dangerous for the 
patient to expose himself to the open air for a considerable 
time after the bath. The therapeutic influence of this 
application is most evident in chronic articular enlargements, 
rheumatic-arthritis, some indolent tumours, intractable cases 
of secondary syphilis, and rheumatism. 

The next spa in our itinerary is Abano, the birthplace of 
Livy, which also lies in the same fertile province of Lom- 
bardy as Acqui, and is only six miles from Padua. Small 
as the place is, the bath establishment and the accommodation 
for visitors are both excellent. 

The springs issue from the foot of the Euganean hills, and 
belong to the class of hot sulphurous saline waters. As at 
Franzensbad and Acqui, the sulphurous mud of Abano is used 
for local and general baths. The effects of these mud-baths 
differs so little from those of others of the same kind that 
they need not be redescribed. 

Tuscany contains several important spas • the first of which 
that I visited was Pisa, where the mineral baths have been 



PISA AND LUCCA. 265 

in use since the middle of the twelfth century. The thermal 
sources rise from a calcareous spar rock, at the foot of Mount 
St Julian, where, within an area of seventy paces, there are 
no less than twelve springs, which vary in temperature 
from 106° to 81°. They all belong to the class of thermal 
salines, and leave a calcareous incrustation in the wells, 
even in the baths a pellicle of the same character, consisting 
of salts of lime and magnesia, floats on the surface of the 
water. 

The Pisan mineral springs are used internally in chronic 
hepatic complaints; in gravel, and some renal affections, in 
chlorosis, in dysentery and dyspepsia, attended with pain and 
vomiting. The warm baths are employed in the treatment of 
gout and rheumatism, impaired power, and enlargement of the 
joints ; also in certain chronic ulcers and skin diseases. 

From Pisa, a journey of less than an hour, by the " Strada 
Perrata dell' Alta Italia," brings us to Lucca, five leagues from 
which are the baths of the same name. They are situated at 
the foot of Monte Corsena, in one of the prettiest valleys in 
Tuscany. The watering-place itself consists of a long street of 
handsome hotels, shops, and lodging-houses, and nothing 
seems left undone to render this place one of the most 
agreeable residences in Italy. 

There are five or six bathing establishments, one of which is 
reserved for the poor gratuitously, and the charges of all are 
extremely moderate. The various sources differ little from 
each other, except in temperature, in which they vary from 
88° to 133°. The principal mineral ingredients of the Lucca 
springs are the sulphates of magnesia, lime, and aluminia, 
together with smaller quantities of the carbonates and 
chlorides of the same bases, also silicate of iron, and traces of 
iodine and bromine, the total amount of saline matter being 
about fifteen grains in each pint. 



266 MONTE-CATINO AND POKKETTA. 

Some of the bath-houses of Lucca were constructed early in 
the sixteenth century ; and ever since that time the soothing 
and sedative properties of these waters have widely extended 
their employment in the treatment of cases of chronic rheuma- 
tism, leucorrhcea, catarrhal affections of the urinary organs, 
dyspepsia, and certain cutaneous diseases. 

Besides Pisa and Lucca, Tuscany contains many other spas, 
as for instance, Monte Catino between Lucca and Pistoia, 
The two principal sources are muriated salines, having tem- 
perature respectively of 68° and 86°. Both these contain 
sulphates of lime and aluminia, muriate of soda, and carbonic 
acid ; but in such different proportions, that one, that known 
as the "Tettuccio," is strongly purgative, while the other, 
the " Bagnuola," is only slightly aperient. The latter is 
generally prescribed, and is used chiefly in enlargements of 
the liver, and in cases of chronic dysentery. 

Near Florence are the warm springs of San Casciano, and 
in the same department the sulphurous waters of Voltekra, 
with several others. In the old Eoman States the only 
spas I had any opportunity of seeing were the warm salines 
of Civita Yecchia, which have a temperature of 86°. 
The Campagna also abounds in hot sulphurous springs, and 
at Viteebo and Poeretta are similar sources. The latter of 
these is the most important. It is strongly sulphurous and 
very gaseous, the gas consisting principally of carburetted 
hydrogen, a circumstance of which the guides often take 
advantage, to startle unscientific visitors, by approaching a 
torch over the well, on which the gas takes fire, and a 
luminous vapour floats over the water. Besides their sul- 
phurous constituents, the sources of Porretta contain a great 
quantity of organic matter, and salts of lime and soda, with 
traces of iodine. The taste is bituminous and nauseous, and 
the temperature varies from 86° to 100°. The action of 



CASTELLAMAKE. 267 

Porretta water is strongly purgative and diuretic. It is used 
internally as well as for baths, in the treatment of enlarge- 
ments and congestions of the abdominal viscera, and in 
chronic skin diseases. 

From the Eoman to the Neapolitan spas the transition is 
natural ; and with a brief account of the latter I shall close 
this chapter and my work. 

Some years ago, having had occasion to pass a summer 
in Naples, I occupied myself in visiting the neighbouring 
watering-places, the most celebrated of which, Castellamare, 
enjoys a high reputation with Neapolitan physicians in the 
treatment of chronic rheumatism and gout. 

Four of the Castellamare sources contain salts of iron, the 
principal being the "Acqua Ferrata," rising in the Strada 
Cantieri. Four of the wells are saline, their chief ingre- 
dients being muriate and sulphate of soda, with chloride of 
calcium. Four are sulphurous and chalybeate, containing 
sulphate of iron, with a large volume of sulphuretted 
hydrogen gas. These, though so distinct in character, all 
rise within a small area at the base of the hill on which the 
town stands. 

The physiological and therapeutic action of the various 
mineral springs are, as is indicated by the foregoing classi- 
fication, necessarily very different. The ferruginous ones, 
especially the " Acqua Ferrata del Pozzillo," are very powerful 
chalybeates. The "Acqua Media "is a saline aperient, not 
unlike Seltzer water in taste. 

The action of the suphurous springs of Castellamare need 
not be here described, as they are similar in effect to others 
of the same class, and are chiefly used by the local physicians 
in the treatment of chronic skin diseases, and arthritic 
affections. 

On the opposite side of the Bay of Naples from Castella- 



268 THE SPAS OF ISCHIA. 

mare, lies the island of Ischia, the next and last of the 
watering-places which I have to describe. Ischia presents, 
on every side, the most unmistakable proofs of the volcanic 
convulsions of which it has been the scene, and on Monte 
Epomeo twelve separate volcanic cones may still be traced. 
This mountain, which gives Ischia its peculiar pyramidal 
aspect, rises in the centre of the island, in a series of highly- 
cultivated terraces, to the height of between 2000 and 3000 
feet. 

In summer Ischia is much frequented by the Neapolitans, 
as a cool maritime residence ; but its chief recommendation 
at all seasons is the reputation of its mineral waters. There 
are three small towns on the island. Of these Casamicciola is 
the most resorted to, is prettily situated on a rising ground 
near the sea, has a population of about 3000 inhabitants, 
contains some comfortable lodging-houses, and is quite close 
to the mineral sources. 

The Gurgitello, which is the most frequented spring, 
rises in the Val Ombrasco, near Casamicciola. The temper- 
ature of the water is 167°, and its chief ingredients are muriate 
of soda, carbonate of soda, and sulphates of soda and lime, 
together with a large amount of free carbonic acid gas. Its 
medicinal use is almost entirely in the form of baths, in diseases 
of the periosteum, and in the treatment of sciatica and chronic 
rheumatism. 

The Acqua di Citara rises on a sandy bay, about a mile 
south of Foria. Its temperature is 120°, and its principal 
constituents are sulphate and muriate of soda. Its action 
is chiefly that of a refrigerent and saline laxative, and it is, 
moreover, used in certain uterine complaints, and in some 
diseases of the female breast. 

The Acqua di Cappone somewhat resembles Wiesbaden 
water in its similarity of flavour to weak chicken broth. The 



THE SPAS OF ISCHIA. 269 

temperature is 98°, and it differs from the Gurgitello princi- 
pally in strength. Its chief use is in dyspepsia and chronic 
gastro-intestinal derangements, and also in some uterine 
affections. 

The Acqua di Bagno Fresco is an alkaline water, said to 
possess the property of rendering the skin white and soft, and 
therefore specially resorted to by the Neapolitan fair, as well 
as by those suffering from certain chronic skin diseases, in 
which a stimulating remedy is required. 

The " Stufe," or natural vapour baths, of Castiglione, in the 
mound of lava close to Lacco, are heated by steam, rising 
through crevices, in two small chambers, in the mass of lava. 
The temperature of the steam baths is 130°, and they are 
employed in the treatment of chronic rheumatism, gout, 
and rheumatic-arthritis of long standing. They are also 
sometimes prescribed in obstinate skin diseases. As, how- 
ever, these baths are powerful stimulants and excitants, 
they should on no account be used in any case without the 
advice of a local physician. 

My task ends here. I have now accompanied my reader 
through the principal Southern Health Eesorts and Foreign 
Spas ; and, as I trust, aided the valetudinarian traveller in 
pursuit of health, with the counsel of his medical adviser, to 
select the climate or mineral water most suitable for his 
condition. 



INDEX. 



Aachen (see Aix-la-Chapelle), 
Abano, the baths of, 
Abdominal plethora, treat 

ment of, by mineral 

waters, 
Abstinence, therapeutic effects 

of, . . . 
Acqua Ferrata del Pozzillo 
Acqui, 

Adelheidsquelle, . 
Air, change of, its remedial 

influence, 
Aix-la-Chapelle, . 
Aix-les-Bains, 
Alameda, of Malaga, the, 
Alexandria, . 

Algiers, the city of, described 
the climate, 
prevailing diseases, 
therapeutic uses of this 

climate, 
Alicante, 

Alkaline mineral waters, 
Almeria, 
Alpine climates, in treatment 

of phthisis, 
Altitude, effects on a cli 

mate, 
Am elie-les- Bains, 
Anaemia, its treatment by 

mineral waters, 128, 
Andalusia, its climates, 
Antequera Mountains, 
Andes, climate of the, . 
Apollinaris water, source of 

the, ... 

Apoplexy, induced by ther- 
mal baths, 
treatment of, by saline 

waters, 
Aperient Waters, 
Appetite, effects of travelling 

on the, 
Angelez, 

Arcachon, .... 
Aries, . 



PAGE 

264 

177 

139, 198 
267 
263 
131 

3-17 

160-162 

236-238 

30 

113-115 

53-54 

55-57 

58-59 

60-61 

22 

130 

22 

9-11 

11 
253 

158, 168 

23-41 

37 

10 

180 

138 

208 
130, 206 

134 

248 

76 

253 



Armand Dr, of Algiers, cited, 
Arno, Valley of the, 
Arweiler, .... 
Assouan, .... 
Asthma, change of climate in 

treatment of, 12, 51 

Atlas Mountains, climate of 

the, .... 
Australia, "Western, climate 

of, . . . 
Austrian watering-places, 
Auteuil, 

Auvergne, spas of, 
Azores, the climate of the, 



PAGB 

55 

97 

180 

122 

75 



56 



191-212 

259 

239-144 

52 



Baden-Baden, 

Baden on the Limmat, 

Baden near Vienna, 

Bagneres de Biggore, 

Bagneres de Luchon, 

Barcelona, . 

Bareges, 

Barisart, 

Bath, . 

Baths, thermal, observations 

on their use and abuse, 
Bavarian mineral waters, 
Bayonne, 
Belgium, spas of, 
Bex, .... 
Biarritz, 

Bilin, .... 
Birmenstorf, 
Bitter- waters, the, 
Black Forrest, the, 
Booklet, 

Bohemia the Spas of, . 
Borcette, (or Burtscheid), 
Bordighera, 

Bourbonne-les-Bains, . 
Breast, Kreuznach water in 

diseases of the, 
Bright's Disease, Bilin water 

in treatment of, 
British winter-resorts, 
Bournemouth, 



218-220 
221-223 
211 
246 
252 
19, 20 
250 
158 
131 

135-138 

186-190 

77 

154-160 

129 

77 

205 

130 

205 

214 

189-190 

191-208 

163 

96 

129 

182 

205 
8 
8 



272 



INDEX. 



Bronchitis chronic, change of 


Consumption, its treatment— 




climate in, 


12 


by change of climate, . 


1-11 


mineral waters in treat 




by mineral waters, 


184, 255 


ment of, . 


. 189, 219 


epidemic in hot climates, 


39 


Bromated spas, . 


131 


Contrexville, waters of, 


262 


Briickenau, 


189 


Cornaro's dietary, 


139 


Bruges, 


154 


Corrigan, Sir Dominic, quoted, 76 


Buxton, 


145 


Crontal, .... 


126 






Cusset, .... 


242 


Cadix, 


23 






Cairo, 


115 


Davos, .... 


10 


Calculi, their treatment bj 




Dax, ..... 


258 


mineral waters, 


217-241 


Diabetes, Vichy water in 




Caladas da Rainha, 


128 


treatment of, 


241 


Canaries, climate of the, 


51 


Diet, its influence on health 




Cannes, . 


85-87 


and disease, 


139 


Cannstatt, . 


213 


Dobell, Dr, cited, 


120 


Cape of Good Hope, 


9 


Dolmens of Algeria, the, 


55 


Carratraca, . 


34 


Driburg, 


128 


Carbonic acid in minera 


I 


Dyspepsia, its treatment by 




waters, 


190 


mineral waters, 


139-141 


Carlsbad, .... 


171-196 


Dyspepsia, gouty, 


145, 241 


Cartagena, . 


22 






Casamicciola, 


268 


Earthy Springs, account of the 




Castel Jaloux, 


245 


so-called, . 


130 


Castellamare, 


267 


Eaux-Bonnes, 


254 


Castera-Verduzan 


245 


Eaux-Chaudes, . 


256 


Cathedral of Seville, . 


25 


Eger, .... 


200 


Cauterets, .... 


248 


Egypt and its climates, 


113-123 


Cette, ..... 


80 


Elmen, .... 


131 


Ceuta, .... 


68 


Elephantiasis Arabum, 


Q6 


Chalybeate waters, 


128 


El-Araiche .... 


68 


Change of climate, its effects- 




El-Garb, climate of, 


65 


in consumption, . 


1-11 


Ems, 


164 


in chronic bronchitis, . 


13 


Engadine, the Upper, its 




in other chronic diseases, 


14-17 


climate and scenery, . 


232 


Chaudfontaine, . 


154 


Enghien-les-Bains, 


260 


Chaves, 


130 


English spas used in gouty 




Cheltenham, 


129 


cases, 


145 


Chemically indifferent spring 


s, 131 


English travellers, peculiar- 




Children, effects of change o 


f 


ities of, 


4 


climate on, . 4, 4 


tO, 58, 99 


Enz, valley of the, 


214 


Chiaja of Naples, the, . 


103 


Epidemics, their frequency in 




Chlorosis, mineral waters ir 


L 


Malaga, 


37 


cases of, 


151, 168 


Epsom springs, . 


130 


Cintra, .... 


44 


Exercise of travelling, its 




Civita Vecchia, . 


266 


beneficial effects, 


133 


Clarke, the late Sir James 








cited, 


97 


Fachingen, . 


145 


Climate, its physiological in 




Fashion, itsinfluence on choice 




fiuence, 


. xi.-xiv. 


of health resorts and 




classification of, . 


2 


remedies, . 


147 


Climacteric disease, 


15 


Fata Morgana, the, 


108 


Clothing in warm climateSj 




Fevers, endemic in Algeria, 


58 


rules for, '. 


16 


intermittent treatment 




Coire, .... 


231 


by mineral waters, 


158 


Cold mineral waters, , 


126 


Fielding's voyage to Lisbon, 


42 


Col de Torte, 


254 


" Fondas," of Malaga, 


30 


Constipation, habitual, salim 




France, the south of, its 




mineral water in cases 


3f, 2C8 


climates, . 


69-96 



INDEX. 



273 



PAGE 

Franzensbad, . . . 200-202 

French, spas, account of the, 236-262 
Friedrichshall, water, . . 130 

Funchal, climate of, . . 49 

Gas-baths of Marienbad, de- 
scribed, . -. . 199 
Gastein spa. ... 209 
Geilnau, . . . . 145 
Gerona, .... 18 
Gibraltar, the climate of, 25, 27, 28 
Glandular enlargements, treat- 
ment by mineral water, 131, 177 
Glengariffe, . . . . 8 
Gigot-Suard, Dr, cited, . 85 
Gorbersdorf, . . . 10 
Gout, and its treatment by 

mineral waters, . . 142-145 
Gouty dyspepsia, . . 145 

Gouty inflammation of the 

uterus, . . . 148, 149 
Griffiths, Dr, quoted, . . 84 

Gmunden, . . . . 211 

Gozo ..... 110 



Hadjis of Morocco, account of 




the, .... 


63 


Haemorrhoids, mineral water 




in cases of, 


199 


Hall, . .... 


131 


Hamman-Melouane, 


129 


Harrowgate, 


129 


Hastings, .... 


8 


Hotels, Spanish, . 


30 


Homburg-on-the-Hill, . .175 


-178 


Hospitals of Barcelona, 


20 


of Valencia, . 


21 


of Algiers, 


50 


Hunyadi Janos bitter-water, 


130 


Hyeres, .... 


83 


Hygrometric state of atmos- 




phere, its influence on 




climate, 


2 


Hypochondriasis, curative effect 




of change of air in cases 




of, . . 


13 


and of mineral waters, 




134, 187, 


195 


Hysteria, and its treatment by 




spa waters, 


150 



Indigestion (see Dyspepsia). 
Insanity, cure of incipient, by 

change of climate, . 14 

Iodated waters, . . . 131, 151 
Ireland, health - resorts of, 

south-west coast, . 8 

Ischl, 210 

Ischia, spas of, . . 268 

Italy, mineral waters of, . 263-269 



Jauja, Andine valley of, its 

climate, ... 10 

Joints, effects of mineral 
baths in certain chronic 
disease of, . . . 202, 217 

Journey, beneficial effects of a, 
in hypochondriasis and 
nervous complaints, . 125 

Kidneys, diseases of, treated 

by mineral water, . 205, 241 

Khamsin wind of Cairo, the, 119 
Khedive, steamers on the 

Nile, . . . 122 

Kissingen .... 186-189 

Kreuznach .... 180-182 



Langenbriicken . 

Laryngeal affections, treat- 
ment of, by change of 
climate, 

Leamington, 

Leprosy, endemic in Morocco 

"Lest," wind of Madeira, . 

Leuk, or Leukerbad, . 

Lippspringe, 

Lisdoonvarna, 

Lisbon, account of the city, . 
the climate, cases for 
which suitable, . 

Liver, chronic diseases of, 
th eir treatment by min- 
eral svaters, 

Lombard}^, spas of 

Longevity, effects of climate 
on, . 

Lourdes, .... 

Lucca, baths of, . 

Luggage, advice respecting, . 

Lux, ..... 



129 



129 

66 

50 

234 

130 

129 

42-44 

44-47 



196 
263 

50 

247 

265 

xviii. 

251 



Madeira as a winter resort, . 48-51 
Madden, Dr E, E., quoted, . 114 

Malaga, the city, resources 
for invalid visitors, the 
climate, its therapeutic 
advantages, . . 29-41 
Malta, .... 109-112 

Marienbad . . . . 197 

Marlioz, . . . . 238 

Mediterranean, coast of Spain 

described, . . . 18-22 
Mentone, .... 93-95 
Mental rest, its effects on 

bodily health, . . 125 

Mineral waters, their classifi- 
cation and uses, . 124-153 
Mind, effects of travelling on 

the, .... 14-15 
Minnesota, climate of, . 10 



274 



INDEX. 



Mistral wind and its effects . 


PAGE 
90 


Monaco, gambling tables of, 


96 


Mont-Dore-les-Bains . 


243 


Monte-Catino, 


266 


Montpellier, 


79-82 


Moryson, Fynes, cited, 


222 


Morocco, climate of, 


62-68 


Mountain climates, 


9-11 


Mud baths of Franzensbad, . 


201 


of Accmi, 


264 


of Abano, 


264 


Muriated saline waters, 


129 


Mutterlange of Kreuznach, 




the .... 


181 


Naples, .... 


102-105 


Natal, 


9 


Natres, .... 


128 


Nauheim .... 


178 


Neuralgia, its treatment by 




mineral waters, . 


217 


Neapolitan spas, 


267 


Nervi, 


96 


Neuenahr, .... 


179 


Nice, the town, . 


88 


the climate of, 


89 


its employment in pul- 




monary diseases, 


90-92 


Nile, voyage up the, 


122 


Nenndorf, .... 


129 


Oberland, the Bernese, 


234 


Obesity, its treatment by min- 




eral waters, . . ! 


L73, 196 


Old age, change of climate in 




diseases of, 


15, 41 


Ophthalmia, its prevalence — 




in Morocco, 


66 


in Egypt, . 


114 


Orezza, chalybeate water, 


128 


Organic diseases, danger of 




thermal and mineral 




water in certain cases 




of, . . . . 


195 


Ovarian disease, chronic,treat- 




ment of, by iodated and 




bromated spas, . 


148 



Paralysis, curative effects of 
mineral waters in rheu 
matic, 

Palermo, 

Paris, mineral waters near, 

Pau, and its climate, . 

Pau, chalybeate spring, 

Passy, 

Pedestrian journey, remedial 
effects of a, 

Penticosa, . 

Pfeffers, 



174 

106-108 

259, 260 

69-75 

257 

259 

245 

128 

229-231 



Phthisis, (see Consump- 
tion). 
Pisa, as a sedative winter 

climate, 
Pisa, mineral springs of, 
Plague, epidemic of — ■ 

in Malaga, 

in Morocco, 
Plethora, its treatment by 

mineral waters, . 
Plombieres, 
Porretta, 

Portugal (see Lisbon 1 ), . 
Portuguese mineral waters 
Pouhon, the, 
Provence, climates of, . 
Pulmonary diseases, chronic, 

their treatment by 

change of climate, 
Piilhia, . 

Pyramids of Ghizeh, a visit to 

the, .... 
Pyrenees, spas of the, . 
Pyrmont, .... 

Queenstown, climate of, . 8 



97, 98 
265 

37 
66 

173 
261 
266 

130 

158 

83 



1-13 

206 

116-118 
245 
128 



Ragatz, .... 228 

Rheumatism, chronic, its 

treatment — 

by change of air, . . 18 

by mineral water, . . 174, 217 

Rhine, spas of the, . . 166-182 

Riviera del Ponente, climate of, 83 

Rome, 99-101 

Royat, .... 244 



Saidsehutz, .... 




207 


Saline mineral waters, . 




129 


Salzhausen, .... 




131 


Salzkamergut, spas of the, . 




210 


Samaden, .... 


10 


232 


San Casciano, 




266 


San Remo, .... 




96 


Sante Crux, 




51 


Saratoga, .... 




128 


Savona, .... 




96 


Schinznach, 




224 


Schlangenbad, 


169, 


170 


Schonau, .... 




203 


Schwalbach, 


166 


-169 


Sciatica, its cure by Wildbad 






waters, 




217 


Scrofula, its prevalence in 






Algeria, 




59 


Scrofulous diseases, their 






treatment by change 






of climate, 




4 


by mineral waters, 






131, 148, 


182, 


188 



INDEX. 



275 



PAGE 

Sea voyage, remedial effects 

of, ... 7 

Sedative climates, . 3, 48, 97 

Sedlitz, . . . . 207 

Selters, .... 130 

Seville, . . . . 24, 25 

Sicily, climate of, . . 107 

Sirocco, and its effects, . 99 
Skin diseases, chronic, their 
treatment by mineral 

waters, . 131, 170, 212, 225 

Smoking, its effects on health, 46 

Soden, saline waters, . . 184, 185 
Southern health-resorts, pre- 
cautions necessary for 

invalids in, . . 16 

Spa, in Belgium, . . 156-159 

Spas, classification of the . 126 
Spain, southern, its climates 

and health resorts, . 18-41 
Spain, peculiarities of travel- 
ling in, . . . 18 
Spaniards, character of the, 35 
Spezia, .... 96 
Spleen, enlargements of, caused 

by climate of Algiers, 58 
treatment by mineral 

waters, . . . 188 

Sprudel of Nauhein, . . 178 

of Carlsbad, . . 193 
Sterility, its occasional causes 
and treatment by min- 
eral waters, . .147, 158 

St Michaels, climate of, . 52 

St Moritz, ... 233 

St Nectaire, ... 244 
St Peters, equal temperature 

of, ... . 102 

StSauveur, ... 251 

Stuffe, of Ischia, . . 269 
Sulphurous mineral waters 

128, 160, 224 
Sunlight, its sanitary influ- 
ence, ... 32 
Sutro, Dr, quoted, . . 158 
Switzerland, spas of, . . 220-235 

Tamina, . . . . 229 

Tangiers, .... 62-67 

Tarasp, .... 233 

Tarbes, .... 246 
Temperature of atmosphere, 

its physiological effects, 2, 3 
Teneriffe, the island and its 

climate, ... 51 

Teplitz, .... 203 

Terral wind of Malaga, . 37 

Tetuan, the climate of, . 68 

Thebes, . . . .. 122 



PAGR 

Thermal waters, their nature 

and uses, . 127, 135, 138 
Tonic climates, observations 

on those so-called, . 3 
Torquay, .... 8 
Travelling, its remedial effects, 7, 133 
the art of, . . . xvii. 
Tropical climates, their effects 
on European constitu- 
tions, ... xi. 
Tuffer, .... 131 
Tuscany, the spas of, . 264 
Tunbridge wells, ... 128 

Undercliffe 8 

Upper Egypt, climate of, . 122 
Upper Engadine, health re- 
sorts of the, . . 232 
Uterine diseases, chronic, 
their treatment by 
mineral waters, . . 146-153 



Valencia, .... 


20 


Valetta, .... 


110 


Vals, 


130 


Varicose veins, Homburg 




waters in cases of 


177 


Vega of Malaga, the, . 


33 


Velten, Dr, of Aix-la-Chapelle, 




cited, 


160 


Velez-Malaga, 


34 


Vichy, route to Vichy, the 




town, the geological 




formation of the coun- 




try, the mineral springs, 




their analysis andmecli- 




cinal effects, 


239-242 


Vidago, .... 


130 


Viterbo, .... 


266 


Volcanic action, connection 




of, with thermal 




springs, 


127 


Volterra, .... 


266 


Voltri, .... 


96 


Voyage, sea, remedial effects 




of a, . 


9 


Warmbrunn, 


128 


Weil, M., of Pau, cited, 


73 


Weilbach, .... 


183 


Weilenburg, 


130 


Western Australia, 


9 


Wiesbaden .... 


171-174 


Wildbad, .... 


214 


Wildbad-Gastien, 


209 


Wildegg, .... 


226 


Wilduggen, .... 


130 


Winds, prevailing, their in- 




fluence on climate, 


9 



276 



INDEX. 



PAGE 

Wine, its use and abuse, . 140 

Winter, cough, change of air 

in cases of chronic, . 60, 120 

Women, chronic diseases 

peculiar to, treatment 

of by mineral waters, 146-153 

Woodhallspa, ... 131 

Worthing, .... 8 



Wiirtemberg, mineral waters 

of, . . . . 213-217 

Youth, the so-called fountain 

of, . . . . 170 

Zymotic diseases, their pre- 
valence in Malaga, . 37 



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